More than one million
neonatal deaths every year in the world are attributable to
infection. In nurseries,
infections occur with a reported incidence of 0.3-3%; in Neonatal Intensive Care Units (NICUs) the reported incidence is 7-24.5%, and up to 40% in newborns with
birth weight less than 1000 g or gestational age at birth <28 weeks.
Sepsis is the most severe and frequent
infection, accounting for 45-55% of all
infections. Several practices have been demonstrated to be effective in reducing the incidence of
infection in NICUs, including
hand hygiene practices, correct management of
central venous catheters (CVC), accurate diagnostic strategies and correct use of antimicrobial drugs. Despite the reduction in the incidence of
infection after implementation of these practices,
nosocomial infections are still a relevant problem, with high mortality and morbidity rates in hospitalized newborns, especially preterm newborns. Searching for new strategies to further reduce the incidence of nosocomial
sepsis in NICUs is a priority of clinical research. New and promising strategies for the prevention of
nosocomial infection in NICU include:
lactoferrin administration, early identification of infants at risk of
infection by means of specific markers (e.g.
mannose binding lectin),
heparin use for the prevention of CVC-related
infections, judicious use of
antibiotics, and prevention of fungal
sepsis with
antifungal agents. On the contrary, recent studies demonstrated that the use of specific
immunoglobulins directed against different staphylococcal
antigens is not effective in preventing
neonatal sepsis.