الفهرس 
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Abstract
Although NI is not a recent problem, it still represents a serious problem not only due to the associated morbidity and mortality but also due to the economic burden on patient and hospitals. It continues to be a major world-wide public health problem especially between the neonates in NICU. Moreover, NI takes many forms the most frequent forms are blood stream infection (28%) and ventilator-associated pneumonia (21%). Meningitis, gastroenteritis, skin and eye infection are also common forms.
Hence, the aim of this study was comparison between Monshaat Sultan NICU and Mansoura NICU as regarding the incidence of nosocomial infections identification of the common sites of infections, determination of the causative pathogens and their antibiotic sensitivity patterns, identification of the probable exogenous source from the environment, personnel, or other patients, and determination of significant risk factors and the high-risk group of patients for such infections.
This study was conducted on 3 categories:-Category (1): 41 newborn infants (Patient group). Of which 16 patient from Monshaat Sultan NICU (group 1)and 25 patient from M.U.C.H NICU (group 2)Group 1:where there is 10 females and 6 males and 13 full term and Weight ( X + S.D)=(2.75±0.5 )Group 2:where 14 were females and 11 were males and 18 preterm and full term Age ( X + S.D)=(35±3)Weight ( X + S.D)=(2±0.75)Category (2): 37 medical personnel (physicians, nurses, and workers) of which 20 from Monshaat Sultan and 17 from M.U.C.H NICU Category (3): 102 sites from the environment within the NICU of which 60 sites from Monshaat Sultan and 42 from M.U.C.H as ventilators, incubators, air conditioners, walls, floors, doors, and etc.
Newborns presented at admission with early or late onset neonatal sepsis that proved by clinical examination and laboratory investigations were excluded from the study.
group (A) was subjected to full history taking, through clinical examination including assessment of gestational age by New Ballard Score system and laboratory investigations included C.B.C and CRP. Furthermore, swab samples for culture were taken from 4 different sites (nose, throat, hands and peri-umbilical region); blood cultures with antibiotic sensitivity and septic score were done for discovery of septic neonates.
group (B) swab samples for culture were taken from 3 different sites (nose throat and hands).
group (C) 174 swab samples for culture were taken from 102 sites of the environment as mentioned before.
Results of the study showed that the incidence of NIs was (31%) in Mansoura N.I.C.U(45%) while in Monshaat Sultan N.I.C.U(12%) while cause specific mortality rate 4.8% 2 from Mansoura NICU 1full term and 1 preterm while no reported deaths from Monshaat Sultan N.I.C.U While case fatality rate was 15.3%.Invasive procedures, prolonged hospital stay, prematurity and low birth weight were the most common risk factors for NIs in our study.
The study showed that invasive procedures significantly played an important role as risk factors of NI in NICU. The most important factors are prematurity, sex of patients, excessive use of invasive procedures as cannulation, venous catheter placement, IV fluid administration, ventilation, and duration of hospital stay.
Improper use of antibiotics also contributes to the emergence of resistant strains and increases the rate of HAI.
This study concluded that related strains were frequently found among neonates staff, and environment suggesting cross-contamination. So, rule of staff in NIs occurrence is very important and one of the major keys in prevention of it.
It is recommended that strict adherence to hospital infection control measures and hand hygiene among the hospital staff is the most important factor for preventing nosocomial colonization and infections.