Implementation of NeoKissEs in Spain: A validated surveillance system for nosocomial sepsis in very low birth weight infants

• Published in: Anales de Pediatría 2019-07, Vol.91 (1), p.3-12
• Main Authors: Madrid-Aguilar, Marisela, López-Herrera, María Cruz, Pérez-López, Javier, Escudero-Argaluza, Julene, Santesteban-Otazu, Elena, Piening, Brar, Villate-Navarro, José Ignacio, Pijoán-Zubizarreta, José Ignacio, Laya, Teresa Jesús Agra, Ojembarrena, Almudena Alonso, Sanz, Israel Anquela, Cuevas, Yolanda Armendáriz, Alfonso, Cristina Barcelona, Mosquera, José Beceiro, Caamaño, María Bengoa, Sendín, Elena Bergón, Vilaplana, Lucía Cabanillas, González, Fernando Cabañas, Cogul, Eva Capdevila, Lax, Javier Casanovas, Badía, María Cernada, Cotallo, Gil Daniel Coto, Suárez, Pilar Adelaida Crespo, Terán, María Isabel de las Cuevas, Comeche, Laura Domingo, Martín, Izaskun Dorronsoro, Lorenzo, Pilar Espiño, Bellart, Marta Estalella, Capell, Francisco Javier Estañ, Colomer, Belén Fernández, Trisac, José Luis Fernández, Pradel, Zenaida Galve, Cabezas, Miguel Ángel García, Franco, María García, García, María Jesús García, Rodríguez, Victoria Eugenia García, Mozo, Rafael García, Sánchez, Rubén García, Rodrigo, Fermín García-Muñoz, Esteban, Silvia Garrido, Armengod, Carmen González, Carretero, Paloma González, López, María González, Asencio, María Mercedes Granero, Hernández, José María Hernández, López, María Elena Infante, Sebastián, Ana Irasarri, Parrilla, Francisco J Jiménez, Parrilla, Pedro J Jiménez, Aristizabal, María Isabel Larburu, Azorín, Manuela López, Goya, Juan María López de Heredia, Oliva, Jesús Cecilio López-Menchero, Lagares, Salud Luna, Pérez, Carmen Luz Marrero, Tallo, Emilia María Martínez, Gutiérrez, Andrés Martínez, Jiménez, María Dolores Martínez, Fernández, María de los Ángeles Martínez, Ruiz, Raquel Mendiola, Miralles, María Leticia Millán, Vives, Alicia Mirada, Cabrillana, Jesús Molina, Calderón, Elisenda Moliner, Arnal, Icíar Olabarrieta, Delgado, Antonio Pavón, Legorburu, Alberto Pérez, Muñuzuri, Alejandro Pérez, Pisón, Raquel Pinillos, Gracia, Segundo Rite, Rodríguez, Sonia M Rivero, Blanco, Silvia Rodríguez, Modamio, Gerardo Romera, Roigés, María Dolors Salvia, Fernández, Mario Sánchez, Arenas, Antonio Segado, Mir, Eduard Solé, Busselo, Itziar Sota, Fernández, Joaquín Suárez, Fargueta, José Luis Tarazona, Tripodi, Cinzia, Faci, María Purificación Ventura, González, Javier Vilas
• Format: Article
• Language: English
• Subjects: Bacteriemia; Bloodstream infection; Catheter-associated infection; Cross Infection - epidemiology; Cuidados intensivos; Epidemiological Monitoring; Female; Humans; Infant, Newborn; Infant, Very Low Birth Weight; Infección asociada a catéter; Intensive care; Intensive Care Units, Neonatal - statistics & numerical data; Male; Muy bajo peso; Neonate; Neonato; Nosocomial; Pilot Projects; Population Surveillance - methods; Risk Factors; Sepsis; Sepsis - epidemiology; Spain - epidemiology; Surveillance; Very low birth weight; Vigilancia
• ISSN: 2341-2879; 2341-2879
• DOI: 10.1016/j.anpede.2018.10.001

Bloodstream infections (BSIs) are the most frequent nosocomial infections in neonatal intensive care units (NICUs), especially in very low birth weight (VLBW) infants (birth weight ≤ 1500g). An epidemiologic surveillance system may contribute to the prevention of infection by continuous monitoring of its frequency and associated risk factors. The aim of this article was to describe the implementation of the NeoKissEs surveillance system for BSIs in VLBW newborns in a group of Spanish NICUs. We assessed the clinical cohort consisting of all VLBW newborns aged less than 28 days admitted to the participating units. In the pilot phase, 2NICUs translated and adapted materials from the original German NEO-KISS system. During implementation, 210 health care professionals attended one of 8 educational workshops. A web-based system was created that allows entering data regarding patients and BSI episodes, data monitoring, benchmarking and providing feedback to the units. At each NICU, one neonatologist was responsible for the implementation of the system and reporting the difficulties perceived throughout the process. Out of the 50 units that agreed to participate, 45 successfully started using the surveillance platform during the implementation phase, recording 1108 episodes of catheter-associated BSI (CABSI) in 3638 newborns, and finding an overall rate of CABSI of 18.4 (95% CI, 17.8-19.1) per 1000 catheter days. The NeoKissEs surveillance system constitutes a helpful source of information for the purpose of benchmarking the performance of neonatal units, assessing factors associated with BSI in VLBW infants and measuring the impact of future preventive interventions in NICUs. Las sepsis son las infecciones nosocomiales más frecuentes en las Unidades de Cuidados Intensivos Neonatales (UCIN), afectando especialmente a los recién nacidos de muy bajo peso al nacer (RNMBP, ≤ 1.500g). Un sistema de vigilancia epidemiológica puede contribuir a su prevención mediante una evaluación continua de su frecuencia y factores de riesgo asociados. El objetivo de este artículo es describir la implementación del sistema de vigilancia de las sepsis nosocomiales en RNMBP (NeoKissEs) en un grupo de UCIN españolas. Estudio de cohorte de RNMBP con < 28 días de edad ingresados en las UCIN participantes. Dos UCIN tradujeron y adaptaron materiales a partir del sistema original alemán NEO-KISS. Durante la implementación, se desarrollaron 8talleres formativos, con participación de 210 profe