Nosocomial infections in neonatal intensive care units: cost-effective control strategies in resource-limited countries.

Abstract

Abstract Background: Nosocomial infections or hospital-acquired infections constitute a global health problem. They lead to significant morbidity and mortality in both developed and resource-limited countries. The neonatal intensive care unit (NICU) is a suitable environment for disseminating these infections; underscoring the need for preventive intervention measures.

Objectives: This review aims to highlight the global burden of nosocomial infections in neonatal intensive care units (NICUs), to discuss their epidemiology and clinical spectrum, as well as the costeffective control strategies in resource- limited settings.

Sources: Sources of information were from Google searches and PubMed- linked articles using the key words- nosocomial infections, neonatal intensive care unit, control. Related articles from hard copies of medical literature and journals were also gathered.

Results: Although paucity of data exists on the incidence of nosocomial infections in NICUs in developing countries, reports from developed countries indicate a range of 6% to 25%. Much higher figures were noted in some developing countries. Several risk factors for nosocomial infections were identified but varied in different NICUs surveyed. Effective control strategies have been recommended but hand washing or hand hygiene appears universally applicable in both developed and resource-limited countries. Economic analyses of these strategies in developed countries have established their costeffectiveness while the adaptability of hand hygiene program to resource- limited settings has been demonstrated in a World Health Organization pilot study in sub- Saharan Africa.

Conclusion: Hand washing or hand hygiene by health-care personnel remains the most important evidence- based and cost-effective control strategy for the spread of nosocomial infections in NICUs in resource- limited countries.

Keywords: nosocomial infections; neonatal intensive care unit;control.