Neonatal infections increase mortality, prolong hospital stay and worsen neurodevelopmental outcomes. The Matching Michigan (MM) program initiated in UK Jan 2011, is a care-bundle focused on reducing healthcare-associated infections.
Our report details a year of blood culture positive infections seen on a tertiary neonatal unit at from 2011–2012, comparing 6 months pre and post the introduction of MM.
Results There were 929 babies admitted over this period, of which 27 had proven bloodstream infections corresponding to an infection rate of 29 per 1000 babies. Of these, 3.2 per 1000 were early onset (EOS <72 hrs of life), and 26 per 1000 were late onset (LOS > 72 hrs).
The majority of the LOS infections were coagulase negative staph aureus (CONS) with concomitant presence of central catheter – CR-BSI. There were a total of 2697 line days. 1359 line days were before and 1338 after the introduction of MM, representing an even spread of line days throughout the year.
There were 6.7 CR-BSI per 1000 line days over the year. The rate pre-MM was 4.4 CR-BSI per 1000 line days, compared to 8.9 CR-BSI per 1000 post-MM.
Conclusion We have not seen the expected drop in CR BSI as has been described in adult studies. Our data shows doubling of CR-BSI post MM, raising questions about the implementation process of MM on our unit.
Clinical skills training, stewardship of blood culture results and antibiotic use have all been proposed to improve the number of CR-BSI. More evidence is needed as to the effect of MM in the neonatal population.
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