Prevention of device-associated healthcare-associated infections (DA–HAIs), such as central line-associated bloodstream infection (CLABSI) and ventilator-associated pneumonia (VAP), in neonatal intensive care units (NICUs) continues to receive high priority. Surveillance of the occurrence of DA–HAIs is important for the quality improvement of infection control practices at individual institutions. However, no comprehensive benchmark data about the occurrence of DA–HAIs are available for NICUs in Japan. The present study assessed the occurrence of DA–HAIs and investigated the measures necessary for the improvement of overall surveillance in NICUs in Japan. A retrospective cohort DA–HAI surveillance study was conducted in neonates with birth weight of ≤1500 g who were admitted to Level II/III NICUs between January 2011 and December 2012. The diagnosis of DA–HAIs was based on the criteria of the Center for Disease Control and Prevention National Healthcare Safety Network (CDC/NHSN). This study investigated laboratory-confirmed bloodstream infection (LCBI) and clinical sepsis (CSEP) reported as CLABSI. The obtained data were compared with the 2011 CDC/NHSN data summary for Level II/III NICUs. This study included 9 of the 15 NICUs involved in the study of the “Neonatal Infection Control and Prevention Searching Group” in Japan. Ten cases of LCBI, 17 cases of CSEP, and 40 cases of VAP were reported during the 67,788 patient-days of the study period. The rates of LCBI for the birth weight categories of ≤750 g, 751–1000 g, and 1001–1500 g were 0.7, 0.7, and 0.5 per 1,000 device-days, respectively. These rates were all within the standard ranges of the NHSN data. CSEP accounted for 63.0% of the cases of CLABSI. The rates of VAP for the birth weight categories of ≤750 g, 751–1000 g, and 1001–1500 g were 3.3, 5.0, and 3.6, respectively. These rates were all higher than the 75th percentile level of the NHSN data, and varied greatly among the surveyed NICUs. CSEP accounted for a large proportion of CLABSI cases in this study, suggesting that considerable efforts should be made for the accurate diagnosis of LCBI. Furthermore, to achieve additional improvement of infection control practices in NICUs in Japan, large prospective surveillance studies and analysis of the risk factors for each DA–HAI are necessary.
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