1%, followed by conjunctivitis (6.5%) and pneumonia with clinical diagnosis (6.1%). Of the 522 notifications of HAIs, 489 (93.7%) were filled using both criteria, eight infections were reported only by the national criteria, and 25 only by NHSN criteria. The 25 cases of infection that employed only the NHSN criteria accounted for episodes of early‐ or late‐onset clinical sepsis, while those that used only the national criteria included two cases of conjunctivitis and six of necrotizing enterocolitis (Table 2). The results of the analysis

of national criteria for HAI notification in all topographies show high sensitivity, specificity, PPV, and NPV, in addition to excellent agreement, and are shown in Table 3. It was observed that the sensitivity of the national criteria for notification of sepsis had a relatively lower proportion of notifications, but higher specificity when compared selleck chemicals llc to notification by the NHSN criteria, when the criteria were employed for all topographies. The sensitivity, specificity, PPV, NPV, and Kappa for sepsis notifications using the national criteria are shown in Table 4. The incidence density of HAIs in this study, considering the two surveillance criteria, was 27.28 infections per 1,000 patient‐days, and was higher in the weight range

below 750 g, when compared to the others. The results reinforce the literature data learn more indicating that low birth weight is a risk factor for infections, reflecting the greater need for invasive procedures and prolonged hospitalization in newborns weighing less than 750 g.10 and 11 Topographies with the highest incidence of reported HAIs were sepsis (58.3%), skin infections

(15.1%), and conjunctivitis (6.5%). These results were similar to that of a study conducted in a neonatal intensive care unit (NICU) in Belo Horizonte, Fossariinae state of Minas Gerais, Brazil, which identified sepsis as the main infectious complication in newborns (46%), followed by conjunctivitis (12.1%), and skin infections (9.5%).12 Another study, carried out for five years in Germany, identified sepsis (78%), ventilator‐associated pneumonia (11%), and necrotizing enterocolitis (10%) as the major sites of HAI in neonates weighing less than 1,500 g.13 Among all HAI topographies, clinical sepsis was the neonatal infectious complication with the highest number of notifications, accounting for 37.7% of the total, regardless of the criteria used for notification. The highest incidence of clinical sepsis in neonates can be explained by the difficulty of laboratory confirmation in this population. Confirmation of sepsis is attained by the growth of pathogens in blood culture, or in case of a commensal microorganism, growth in two blood cultures, which is considered the gold standard for the diagnosis of bloodstream infections.