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

BACKGROUND: The aim of this study was to identify the nosocomial infection (NI) risk factors in neonatal Intensive Care Units (NICU). MATERIAL/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.