1. Spatial and environmental correlates of organism colonization and infection in the neonatal intensive care unit.
- Author
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Goldstein ND, Tuttle D, Tabb LP, Paul DA, and Eppes SC
- Subjects
- Cross Infection prevention & control, Delaware epidemiology, Environment, Female, Humans, Infant, Newborn, Infection Control methods, Intubation, Intratracheal adverse effects, Klebsiella Infections epidemiology, Klebsiella Infections prevention & control, Logistic Models, Male, Outcome Assessment, Health Care, Retrospective Studies, Risk Factors, Sepsis epidemiology, Sepsis prevention & control, Spatial Analysis, Staphylococcal Infections epidemiology, Staphylococcal Infections prevention & control, Cross Infection epidemiology, Equipment Contamination, Intensive Care Units, Neonatal, Methicillin-Resistant Staphylococcus aureus
- Abstract
Objective: To examine organism colonization and infection in the neonatal intensive care unit as a result of environmental and spatial factors., Study Design: A retrospective cohort of infants admitted between 2006 and 2015 (n = 11 428), to assess the relationship between location and four outcomes: methicillin-resistant Staphylococcus aureus (MRSA) colonization; culture-confirmed late-onset sepsis; and, if intubated, endotracheal tube colonization with Pseudomonas aeruginosa or Klebsiella pneumonia. Independent risk factors were identified with mixed-effects logistic regression models and Moran's I for spatial autocorrelation., Result: All four outcomes statistically clustered by location; neighboring colonization also influenced risk of MRSA (p < 0.05). For P. aeruginosa, being in a location with space for more medical equipment was associated with 2.61 times the odds of colonization (95% CrI: 1.19, 5.78)., Conclusion: Extrinsic factors partially explained risk for neonatal colonization and infection. For P. aeruginosa, infection prevention efforts at locations with space for more equipment may lower future colonization.
- Published
- 2018
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