INTRODUCTION Neonatal sepsis is a major cause of morbidity and mortality with a higher burden from the low- and middle-income countries. The coronavirus disease 2019 (Covid 19) pandemic has impacted healthcare in various ways including healthcare-associated infections (HAI). The objective of the present study was to determine changes in organism profile and incidence rates of HAI in neonates admitted to the index hospital during the pandemic and compared it with the data from the pre-pandemic period. MATERIALS AND METHODS The study design was a retrospective, observational analysis of data from neonates with culture-positive sepsis, in a tertiary care children's hospital, between January 2018 and December 2021. Pre-Covid (January 2018 to December 2019) and Covid period data (January 2020 to December 2021) were analyzed for the significance of change. RESULTS The prevalence of culture-positive sepsis, in pre-Covid and Covid periods, was 19.55% [95% confidence interval (95% CI) 17.13-21.52)] and 18.36% (CI 16.05-20.74), respectively. HAI rates/1000 patient days increased slightly during the Covid pandemic [7.2% (95% CI 6.98-10.08) to 9.8% (95% CI 9.78-13.67)] mainly due to an increase in fungal HAI (26% pre- vs. 41.5% Covid period). However, the proportion of Gram-negative (GN) infections fell significantly (70.5% vs. 48.6%) during the same period. In the pre-Covid period, Klebsiella followed by Burkholderia cepacia, Acinetobacter spp and Pseudomonas, were the major HAI isolates. During the Covid period, there was a decline in these isolates and Burkholderia spp was not detected. All fungal isolates were Candida species. The case fatality ratio (CFR) from HAI decreased significantly from 38% to 15.45%, mainly due to a decrease in GN HAI. CONCLUSION During Covid pandemic, there was a significant decline in GN HAI and CFR from HAI, due to improved compliance with infection control measures in the neonatal intensive care unit (NICU). At the same time, there was a rise in the fungal HAI, possibly because of a higher proportion of premature, and sick neonates with longer hospital stay and more invasive procedures. Consolidations of gains in infection control and restriction of invasive procedures could help to minimize HAI in NICUs.

中文翻译：

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东印度三级中心新生儿败血症生物体特征的 Covid-period 相关变化。

引言 新生儿败血症是发病率和死亡率的主要原因，在低收入和中等收入国家负担较高。2019 年冠状病毒病 (Covid 19) 大流行以各种方式影响了医疗保健，包括医疗保健相关感染 (HAI)。本研究的目的是确定大流行期间进入指标医院的新生儿的生物体概况和 HAI 发病率的变化，并将其与大流行前时期的数据进行比较。材料和方法 该研究设计是对 2018 年 1 月至 2021 年 12 月期间在一家三级儿童医院中培养阳性脓毒症新生儿的数据进行的回顾性观察分析。分析了疫情前（2018 年 1 月至 2019 年 12 月）和疫情期间数据（2020 年 1 月至 2021 年 12 月）的变化意义。结果 在 Covid 之前和 Covid 时期，培养阳性败血症的患病率分别为 19.55% [95% 置信区间 (95% CI) 17.13-21.52)] 和 18.36% (CI 16.05-20.74)。在 Covid 大流行期间，HAI 率/1000 患者日略有增加 [7.2% (95% CI 6.98-10.08) 至 9.8% (95% CI 9.78-13.67)]，这主要是由于真菌 HAI 增加（26% pre-vs. 41.5% Covid 时期）。然而，同期革兰氏阴性 (GN) 感染的比例显着下降（70.5% 对 48.6%）。在 Covid 之前的时期，主要的 HAI 分离株是克雷伯氏菌，其次是洋葱伯克霍尔德菌、不动杆菌属和假单胞菌。在Covid期间，这些分离株数量减少，并且未检测到伯克霍尔德氏菌属。所有分离的真菌均为念珠菌属。HAI 的病死率 (CFR) 从 38% 显着下降至 15.45%，这主要是由于 GN HAI 的减少。结论 在 Covid 大流行期间，由于新生儿重症监护病房 (NICU) 对感染控制措施的依从性提高，GN HAI 和 HAI 的病死率显着下降。与此同时，真菌性 HAI 有所增加，这可能是因为早产儿和患病新生儿的比例更高，住院时间更长，侵入性手术更多。巩固感染控制和限制侵入性操作的成果可能有助于最大限度地减少 NICU 中的 HAI。HAI 的病死率 (CFR) 从 38% 显着下降至 15.45%，这主要是由于 GN HAI 的减少。结论 在 Covid 大流行期间，由于新生儿重症监护病房 (NICU) 对感染控制措施的依从性提高，GN HAI 和 HAI 的病死率显着下降。与此同时，真菌性 HAI 有所增加，这可能是因为早产儿和患病新生儿的比例更高，住院时间更长，侵入性手术更多。巩固感染控制和限制侵入性操作的成果可能有助于最大限度地减少 NICU 中的 HAI。HAI 的病死率 (CFR) 从 38% 显着下降至 15.45%，这主要是由于 GN HAI 的减少。结论 在 Covid 大流行期间，由于新生儿重症监护病房 (NICU) 对感染控制措施的依从性提高，GN HAI 和 HAI 的病死率显着下降。与此同时，真菌性 HAI 有所增加，这可能是因为早产儿和患病新生儿的比例更高，住院时间更长，侵入性手术更多。巩固感染控制和限制侵入性操作的成果可能有助于最大限度地减少 NICU 中的 HAI。由于新生儿重症监护病房 (NICU) 对感染控制措施的依从性有所提高。与此同时，真菌性 HAI 有所增加，这可能是因为早产儿和患病新生儿的比例更高，住院时间更长，侵入性手术更多。巩固感染控制和限制侵入性操作的成果可能有助于最大限度地减少 NICU 中的 HAI。由于新生儿重症监护病房 (NICU) 对感染控制措施的依从性有所提高。与此同时，真菌性 HAI 有所增加，这可能是因为早产儿和患病新生儿的比例更高，住院时间更长，侵入性手术更多。巩固感染控制和限制侵入性操作的成果可能有助于最大限度地减少 NICU 中的 HAI。