Healthcare-Associated Infections in Chinese Neonates: A Multicenter Retrospective Period Prevalence Survey in Jiangsu Province (2023)

Background Healthcare-associated infections (HAI) pose a significant threat to neonates, especially preterm and critically ill infants, leading to prolonged hospitalization, increased healthcare costs, and elevated mortality. Understanding the epidemiological characteristics of neonatal HAI is of major guiding significance for the development of targeted public health policies and clinical prevention strategies. This study aimed to investigate the epidemiology of neonatal HAI in Jiangsu Province, China, in 2023. Methods A retrospective period prevalence survey was conducted in Jiangsu Province, China, from September to October 2024. Data on neonatal HAI occurring between January and December 2023 were collected using a structured questionnaire. Thirty hospitals from 13 cities ultimately participated and completed the survey. Results Among 36,957 neonates (327,098 patient-days), 370 HAI episodes were identified, yielding a prevalence of 1.0% (95% CI: 0.9%–1.1%). Neonates with a birth weight < 1500 g faced a dramatically higher risk (RR = 17.0, 95% CI: 14.0–20.8; p  < 0.001). The most common infection sites were bloodstream (45.7%), lower respiratory tract (39.2%), and gastrointestinal tract (5.5%). Predominant pathogens included coagulase-negative staphylococci (18.2%) and Klebsiella pneumoniae (17.2%). Device-associated infection rates were 0.7‰ (95% CI: 0.4–1.0) for central line-associated bloodstream infection and 1.2‰ (95% CI: 0.7–1.6) for ventilator-associated pneumonia. Conclusion This first province-wide study reveals a relatively low overall prevalence of HAI among neonates in Jiangsu. Prevention priorities should focus on high-risk neonatal birthweight < 1500 g and bloodstream infections, supported by optimized staffing levels for both nursing and infection preventionist personnel, as well as strengthened microbiological surveillance.