Hospital-Acquired Infections in Neonatal Intensive Care Unit, Gondar, Ethiopia: A Prospective Follow-Up Study

Background Hospital-acquired infections in neonates are common problems with significant effect on neonatal morbidity and mortality. The incidence rates of hospital-acquired infections in neonates are variable and dependent on factors such as the hospital's infection control measures, neonatal intensive care unit (NICU) protocols, and the prevalence of pathogens in the hospital environment. However, little is known about incidence and associated factors in Ethiopia, which was the main aim of our study. Methods A prospective follow-up study was conducted to assess the incidence and associated factors of hospital-acquired infections in neonates admitted to the neonatal intensive care unit of the University of Gondar Hospital from September 1st, 2023, to February 29th, 2024. All neonates admitted to the Neonatal ICU who stayed for ≥ 48 hours were included in the study and participants were selected by systematic random sampling. To identify contributors to HAIs, both bivariate and multivariate Cox regression analyses were applied, and P < = 0.05 was considered statistically significant for association. Results A total of 247 neonates were followed for 2145 patient days. The incidence rate of hospital-acquired infection was 18.2 (95% CI: 11.3–20.3) per 1000 neonatal days of follow-up, and the overall cumulative incidence was 15.8%. Neonates who stayed longer than 7 days (p = 0.041), used CPAP (p = 0.003), and urinary catheter (p = 0.001) were found to have significant risks of developing HAIs. Conclusion The incidence of hospital-acquired infections was high, and the presence of invasive medical devices and longer stays in the hospital were significantly associated with an increased risk of HAI in the NICU.