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Risk Factors of Nosocomial Infection for Infants in Neonatal Intensive Care Units: A Systematic Review and Meta-Analysis

Li Wang, Ke-Ning Du, Yan-Ling Zhao, Ya-Juan Yu, Li Sun, Hong-Bo Jiang

Changchun Children’s Hospital, Changchun, Jilin, China (mainland)

Med Sci Monit 2019; 25:8213-8220

DOI: 10.12659/MSM.917185

Available online:

Published: 2019-11-01

BACKGROUND: The aim of this study was to identify the nosocomial infection (NI) risk factors in neonatal Intensive Care Units (NICU).
MATERIAL AND METHODS: Databases (PubMed, Embase, Cochrane, VANFUN, CNKI, and VTTMS) were searched using index words to find relevant studies published before November 2018. Meta-analyses of relative risk (RR) were performed for the identification of risk factors.
RESULTS: Data from 22 cohort studies (2270 infants with and 21 605 infants without NI) were included in the meta-analysis. Infant weight of <2500 g (RR: 3.44, 95% CI: 2.31-5.11), gestational age of <37 weeks (RR: 3.85, 95% CI: 1.87-7.92), mechanical ventilation use (RR: 3.16, 95% CI: 2.21-4.50), venipuncture (RR: 3.01, 95% CI: 1.20-7.57), the incidence of asphyxia (RR: 1.68, 95% CI: 1.04-2.71), and feeding intolerance (RR: 2.12, 95% CI: 1.60-2.81) were identified as the risk factors for the incidence of NI. There was no significant publication bias.
CONCLUSIONS: This study shows that <2500 g infant body weight, gestational age of <37 weeks, mechanical ventilation utility, venipuncture, asphyxia incidence, and feeding intolerance are the risk factors for NI nosocomial infection in infants in NICU. Appropriate preventive measures and targeted interventions are needed.

Keywords: Behavioral Risk Factor Surveillance System, Cross Infection, meta-analysis