The prevalence and diagnostic criteria of health-care associated infections in neonatal intensive care units in Turkey: A multicenter point- prevalence study
Background: Healthcare-acquired infections (HAIs) in the neonatal period cause substantial morbidity, mortality, and healthcare costs. Our purpose was to determine the prevalence of HAIs, antimicrobial susceptibility of causative agents, and the adaptivity of the Centres for Disease Control and Prev...
Saved in:
| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2021-03-01
|
| Series: | Pediatrics and Neonatology |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1875957221000012 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850198451403358208 |
|---|---|
| author | Tuğba Bedir Demirdağ Esin Koç Hasan Tezer Suna Oğuz Mehmet Satar Özge Sağlam Saime Sündüz Uygun Esra Önal İbrahim Murat Hirfanoğlu Kadir Tekgündüz Nihal Oygür Ali Bülbül Adil Umut Zübarioğlu Nuran Üstün Sezin Ünal Canan Aygün Belma Saygılı Karagöl Ayşegül Zenciroğlu M. Yekta Öncel Adviye Çakıl Sağlık Emel Okulu Demet Terek Nejat Narlı Didem Aliefendioğlu Tuğba Gürsoy Sevim Ünal Münevver Kaynak Türkmen Fatma Kaya Narter Nükhet Aladağ Çiftdemir Serdar Beken Salih Çağrı Çakır Şule Yiğit Asuman Çoban Ayse Ecevit Yalçın Çelik Ferit Kulalı |
| author_facet | Tuğba Bedir Demirdağ Esin Koç Hasan Tezer Suna Oğuz Mehmet Satar Özge Sağlam Saime Sündüz Uygun Esra Önal İbrahim Murat Hirfanoğlu Kadir Tekgündüz Nihal Oygür Ali Bülbül Adil Umut Zübarioğlu Nuran Üstün Sezin Ünal Canan Aygün Belma Saygılı Karagöl Ayşegül Zenciroğlu M. Yekta Öncel Adviye Çakıl Sağlık Emel Okulu Demet Terek Nejat Narlı Didem Aliefendioğlu Tuğba Gürsoy Sevim Ünal Münevver Kaynak Türkmen Fatma Kaya Narter Nükhet Aladağ Çiftdemir Serdar Beken Salih Çağrı Çakır Şule Yiğit Asuman Çoban Ayse Ecevit Yalçın Çelik Ferit Kulalı |
| author_sort | Tuğba Bedir Demirdağ |
| collection | DOAJ |
| description | Background: Healthcare-acquired infections (HAIs) in the neonatal period cause substantial morbidity, mortality, and healthcare costs. Our purpose was to determine the prevalence of HAIs, antimicrobial susceptibility of causative agents, and the adaptivity of the Centres for Disease Control and Prevention (CDC) criteria in neonatal HAI diagnosis. Methods: A HAI point prevalence survey was conducted in the neonatal intensive care units (NICUs) of 31 hospitals from different geographic regions in Turkey. Results: The Point HAI prevalence was 7.6%. Ventilator-associated pneumonia (VAP) and central line-associated bloodstream infections (CLABSI) and late onset sepsis were predominant. The point prevalence of VAP was 2.1%, and the point prevalence of CLABSI was 1.2% in our study. The most common causative agents in HAIs were Gram-negative rods (43.0%), and the most common agent was Klebsiella spp (24.6%); 81.2% of these species were extended spectrum beta-lactamase (ESBL) (+). Blood culture positivity was seen in 33.3% of samples taken from the umbilical venous catheter, whereas 0.9% of samples of peripherally inserted central catheters (PICCs) were positive. In our study, 60% of patients who had culture positivity in endotracheal aspirate or who had purulent endotracheal secretions did not have any daily FiO2 change (p = 0.67) and also 80% did not have any increase in positive end-expiratory pressure (PEEP) (p = 0.7). On the other hand, 18.1% of patients who had clinical deterioration compatible with VAP did not have endotracheal culture positivity (p = 0.005). Conclusions: Neonatal HAIs are frequent adverse events in district and regional hospitals. This at-risk population should be prioritized for HAI surveillance and prevention programs through improved infection prevention practices, and hand hygiene compliance should be conducted. CDC diagnostic criteria are not sufficient for NICUs. Future studies are warranted for the diagnosis of HAIs in NICUs. |
| format | Article |
| id | doaj-art-decfab6c3f5a433e93f5931e149a22e1 |
| institution | OA Journals |
| issn | 1875-9572 |
| language | English |
| publishDate | 2021-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Pediatrics and Neonatology |
| spelling | doaj-art-decfab6c3f5a433e93f5931e149a22e12025-08-20T02:12:53ZengElsevierPediatrics and Neonatology1875-95722021-03-0162220821710.1016/j.pedneo.2021.01.001The prevalence and diagnostic criteria of health-care associated infections in neonatal intensive care units in Turkey: A multicenter point- prevalence studyTuğba Bedir Demirdağ0Esin Koç1Hasan Tezer2Suna Oğuz3Mehmet Satar4Özge Sağlam5Saime Sündüz Uygun6Esra Önal7İbrahim Murat Hirfanoğlu8Kadir Tekgündüz9Nihal Oygür10Ali Bülbül11Adil Umut Zübarioğlu12Nuran Üstün13Sezin Ünal14Canan Aygün15Belma Saygılı Karagöl16Ayşegül Zenciroğlu17M. Yekta Öncel18Adviye Çakıl Sağlık19Emel Okulu20Demet Terek21Nejat Narlı22Didem Aliefendioğlu23Tuğba Gürsoy24Sevim Ünal25Münevver Kaynak Türkmen26Fatma Kaya Narter27Nükhet Aladağ Çiftdemir28Serdar Beken29Salih Çağrı Çakır30Şule Yiğit31Asuman Çoban32Ayse Ecevit33Yalçın Çelik34Ferit Kulalı35Gazi University, Faculty of Medicine, Department of Pediatric Infectious Diseases, Ankara, Turkey; Corresponding author. Gazi University, Faculty of Medicine, Block D 2nd Floor, Yenimahalle, Ankara, Turkey. Fax: +903125969912.Gazi University, Faculty of Medicine, Department of Neonatology, Ankara, TurkeyGazi University, Faculty of Medicine, Department of Pediatric Infectious Diseases, Ankara, TurkeyUniversity of Health Sciences, Zekai Tahir Burak Women's Health Education and Research Hospital, Department of Neonatology, Ankara, TurkeyÇukurova University, Faculty of Medicine, Department of Neonatology, Adana, TurkeyUniversity of Health Sciences, Kanuni Sultan Süleyman Training and Research Hospital, Department of Neonatology, Istanbul, TurkeyKonya Selcuk University, Faculty of Medicine, Department of Neonatology, Konya, TurkeyGazi University, Faculty of Medicine, Department of Neonatology, Ankara, TurkeyGazi University, Faculty of Medicine, Department of Neonatology, Ankara, TurkeyAtatürk University, Faculty of Medicine, Department of Neonatology, Erzurum, TurkeyAkdeniz University, Faculty of Medicine, Department of Neonatology, Antalya, TurkeyUniversity of Health Sciences, Sisli Etfal Training and Research Hospital, Department of Neonatology, Istanbul, TurkeyYeni Yüzyıl University Faculty of Medicine, Department of Neonatology, Istanbul, TurkeyMedeniyet University. Goztepe Training and Research Hospital, Department of Neonatology, Istanbul, TurkeyUniversity of Health Sciences, Etlik Zübeyde Hanim Women's Health Training and Research Hospital, Department of Neonatology, Ankara, TurkeyOndokuz Mayıs University, Faculty of Medicine, Department of Neonatology, TurkeyUniversity of Health Sciences, Gülhane Training and Research Hospital, Department of Neonatology, Ankara, TurkeyUniversity of Health Sciences, Dr. Sami Ulus Maternity and Children Education and Research Hospital, Department of Neonatology, Ankara, TurkeyUniversity of Health Sciences Izmir Tepecik Training and Research Hospital, Department of Neonatology, Izmir, TurkeyOsmangazi University, Faculty of Medicine, Department of Neonatology, Eskisehir, TurkeyAnkara University, Faculty of Medicine, Department of Neonatology, Ankara, TurkeyEge University, Faculty of Medicine, Department of Neonatology, Izmir, TurkeyMetro Private Hospital, Neonatology Unit, Adana, TurkeyKırıkkale University, Faculty of Medicine, Department of Neonatology, Kırıkkale, TurkeyKoc University, Faculty of Medicine, Department of Neonatology, Istanbul, TurkeyUniversity of Health Sciences, Ankara Hematology Oncology Children's Training and Research Hospital, Department of Neonatology, Ankara, TurkeyAdnan Menderes University, Faculty of Medicine, Department of Neonatology, Aydın, TurkeyUniversity of Health Sciences, Kartal Dr Lutfi Kirdar Training and Research Hospital, Department of Neonatology, Istanbul, TurkeyTrakya University, Faculty of Medicine, Department of Neonatology, Edirne, TurkeyAcıbadem University, Faculty of Medicine, Department of Neonatology, Istanbul, TurkeyUludağ University, Faculty of Medicine, Department of Neonatology, Bursa, TurkeyHacettepe University, Faculty of Medicine, Department of Neonatology, Ankara, TurkeyIstanbul University, Faculty of Medicine, Department of Neonatology, Istanbul, TurkeyBaskent University, Faculty of Medicine, Department of Neonatology, Ankara, TurkeyMersin University, Faculty of Medicine, Department of Neonatology, Mersin, TurkeyUniversity of Health Sciences, Dr. Behcet Uz Children's Health and Diseases and Surgery Training and Research Hospital, Department of Neonatology, Izmir, TurkeyBackground: Healthcare-acquired infections (HAIs) in the neonatal period cause substantial morbidity, mortality, and healthcare costs. Our purpose was to determine the prevalence of HAIs, antimicrobial susceptibility of causative agents, and the adaptivity of the Centres for Disease Control and Prevention (CDC) criteria in neonatal HAI diagnosis. Methods: A HAI point prevalence survey was conducted in the neonatal intensive care units (NICUs) of 31 hospitals from different geographic regions in Turkey. Results: The Point HAI prevalence was 7.6%. Ventilator-associated pneumonia (VAP) and central line-associated bloodstream infections (CLABSI) and late onset sepsis were predominant. The point prevalence of VAP was 2.1%, and the point prevalence of CLABSI was 1.2% in our study. The most common causative agents in HAIs were Gram-negative rods (43.0%), and the most common agent was Klebsiella spp (24.6%); 81.2% of these species were extended spectrum beta-lactamase (ESBL) (+). Blood culture positivity was seen in 33.3% of samples taken from the umbilical venous catheter, whereas 0.9% of samples of peripherally inserted central catheters (PICCs) were positive. In our study, 60% of patients who had culture positivity in endotracheal aspirate or who had purulent endotracheal secretions did not have any daily FiO2 change (p = 0.67) and also 80% did not have any increase in positive end-expiratory pressure (PEEP) (p = 0.7). On the other hand, 18.1% of patients who had clinical deterioration compatible with VAP did not have endotracheal culture positivity (p = 0.005). Conclusions: Neonatal HAIs are frequent adverse events in district and regional hospitals. This at-risk population should be prioritized for HAI surveillance and prevention programs through improved infection prevention practices, and hand hygiene compliance should be conducted. CDC diagnostic criteria are not sufficient for NICUs. Future studies are warranted for the diagnosis of HAIs in NICUs.http://www.sciencedirect.com/science/article/pii/S1875957221000012health-care associated infectionneonatepoint prevalencesurveillance |
| spellingShingle | Tuğba Bedir Demirdağ Esin Koç Hasan Tezer Suna Oğuz Mehmet Satar Özge Sağlam Saime Sündüz Uygun Esra Önal İbrahim Murat Hirfanoğlu Kadir Tekgündüz Nihal Oygür Ali Bülbül Adil Umut Zübarioğlu Nuran Üstün Sezin Ünal Canan Aygün Belma Saygılı Karagöl Ayşegül Zenciroğlu M. Yekta Öncel Adviye Çakıl Sağlık Emel Okulu Demet Terek Nejat Narlı Didem Aliefendioğlu Tuğba Gürsoy Sevim Ünal Münevver Kaynak Türkmen Fatma Kaya Narter Nükhet Aladağ Çiftdemir Serdar Beken Salih Çağrı Çakır Şule Yiğit Asuman Çoban Ayse Ecevit Yalçın Çelik Ferit Kulalı The prevalence and diagnostic criteria of health-care associated infections in neonatal intensive care units in Turkey: A multicenter point- prevalence study Pediatrics and Neonatology health-care associated infection neonate point prevalence surveillance |
| title | The prevalence and diagnostic criteria of health-care associated infections in neonatal intensive care units in Turkey: A multicenter point- prevalence study |
| title_full | The prevalence and diagnostic criteria of health-care associated infections in neonatal intensive care units in Turkey: A multicenter point- prevalence study |
| title_fullStr | The prevalence and diagnostic criteria of health-care associated infections in neonatal intensive care units in Turkey: A multicenter point- prevalence study |
| title_full_unstemmed | The prevalence and diagnostic criteria of health-care associated infections in neonatal intensive care units in Turkey: A multicenter point- prevalence study |
| title_short | The prevalence and diagnostic criteria of health-care associated infections in neonatal intensive care units in Turkey: A multicenter point- prevalence study |
| title_sort | prevalence and diagnostic criteria of health care associated infections in neonatal intensive care units in turkey a multicenter point prevalence study |
| topic | health-care associated infection neonate point prevalence surveillance |
| url | http://www.sciencedirect.com/science/article/pii/S1875957221000012 |
| work_keys_str_mv | AT tugbabedirdemirdag theprevalenceanddiagnosticcriteriaofhealthcareassociatedinfectionsinneonatalintensivecareunitsinturkeyamulticenterpointprevalencestudy AT esinkoc theprevalenceanddiagnosticcriteriaofhealthcareassociatedinfectionsinneonatalintensivecareunitsinturkeyamulticenterpointprevalencestudy AT hasantezer theprevalenceanddiagnosticcriteriaofhealthcareassociatedinfectionsinneonatalintensivecareunitsinturkeyamulticenterpointprevalencestudy AT sunaoguz theprevalenceanddiagnosticcriteriaofhealthcareassociatedinfectionsinneonatalintensivecareunitsinturkeyamulticenterpointprevalencestudy AT mehmetsatar theprevalenceanddiagnosticcriteriaofhealthcareassociatedinfectionsinneonatalintensivecareunitsinturkeyamulticenterpointprevalencestudy AT ozgesaglam theprevalenceanddiagnosticcriteriaofhealthcareassociatedinfectionsinneonatalintensivecareunitsinturkeyamulticenterpointprevalencestudy AT saimesunduzuygun theprevalenceanddiagnosticcriteriaofhealthcareassociatedinfectionsinneonatalintensivecareunitsinturkeyamulticenterpointprevalencestudy AT esraonal theprevalenceanddiagnosticcriteriaofhealthcareassociatedinfectionsinneonatalintensivecareunitsinturkeyamulticenterpointprevalencestudy AT ibrahimmurathirfanoglu theprevalenceanddiagnosticcriteriaofhealthcareassociatedinfectionsinneonatalintensivecareunitsinturkeyamulticenterpointprevalencestudy AT kadirtekgunduz theprevalenceanddiagnosticcriteriaofhealthcareassociatedinfectionsinneonatalintensivecareunitsinturkeyamulticenterpointprevalencestudy AT nihaloygur theprevalenceanddiagnosticcriteriaofhealthcareassociatedinfectionsinneonatalintensivecareunitsinturkeyamulticenterpointprevalencestudy AT alibulbul theprevalenceanddiagnosticcriteriaofhealthcareassociatedinfectionsinneonatalintensivecareunitsinturkeyamulticenterpointprevalencestudy AT adilumutzubarioglu theprevalenceanddiagnosticcriteriaofhealthcareassociatedinfectionsinneonatalintensivecareunitsinturkeyamulticenterpointprevalencestudy AT nuranustun theprevalenceanddiagnosticcriteriaofhealthcareassociatedinfectionsinneonatalintensivecareunitsinturkeyamulticenterpointprevalencestudy AT sezinunal theprevalenceanddiagnosticcriteriaofhealthcareassociatedinfectionsinneonatalintensivecareunitsinturkeyamulticenterpointprevalencestudy AT cananaygun theprevalenceanddiagnosticcriteriaofhealthcareassociatedinfectionsinneonatalintensivecareunitsinturkeyamulticenterpointprevalencestudy AT belmasaygılıkaragol theprevalenceanddiagnosticcriteriaofhealthcareassociatedinfectionsinneonatalintensivecareunitsinturkeyamulticenterpointprevalencestudy AT aysegulzenciroglu theprevalenceanddiagnosticcriteriaofhealthcareassociatedinfectionsinneonatalintensivecareunitsinturkeyamulticenterpointprevalencestudy AT myektaoncel theprevalenceanddiagnosticcriteriaofhealthcareassociatedinfectionsinneonatalintensivecareunitsinturkeyamulticenterpointprevalencestudy AT adviyecakılsaglık theprevalenceanddiagnosticcriteriaofhealthcareassociatedinfectionsinneonatalintensivecareunitsinturkeyamulticenterpointprevalencestudy AT emelokulu theprevalenceanddiagnosticcriteriaofhealthcareassociatedinfectionsinneonatalintensivecareunitsinturkeyamulticenterpointprevalencestudy AT demetterek theprevalenceanddiagnosticcriteriaofhealthcareassociatedinfectionsinneonatalintensivecareunitsinturkeyamulticenterpointprevalencestudy AT nejatnarlı theprevalenceanddiagnosticcriteriaofhealthcareassociatedinfectionsinneonatalintensivecareunitsinturkeyamulticenterpointprevalencestudy AT didemaliefendioglu theprevalenceanddiagnosticcriteriaofhealthcareassociatedinfectionsinneonatalintensivecareunitsinturkeyamulticenterpointprevalencestudy AT tugbagursoy theprevalenceanddiagnosticcriteriaofhealthcareassociatedinfectionsinneonatalintensivecareunitsinturkeyamulticenterpointprevalencestudy AT sevimunal theprevalenceanddiagnosticcriteriaofhealthcareassociatedinfectionsinneonatalintensivecareunitsinturkeyamulticenterpointprevalencestudy AT munevverkaynakturkmen theprevalenceanddiagnosticcriteriaofhealthcareassociatedinfectionsinneonatalintensivecareunitsinturkeyamulticenterpointprevalencestudy AT fatmakayanarter theprevalenceanddiagnosticcriteriaofhealthcareassociatedinfectionsinneonatalintensivecareunitsinturkeyamulticenterpointprevalencestudy AT nukhetaladagciftdemir theprevalenceanddiagnosticcriteriaofhealthcareassociatedinfectionsinneonatalintensivecareunitsinturkeyamulticenterpointprevalencestudy AT serdarbeken theprevalenceanddiagnosticcriteriaofhealthcareassociatedinfectionsinneonatalintensivecareunitsinturkeyamulticenterpointprevalencestudy AT salihcagrıcakır theprevalenceanddiagnosticcriteriaofhealthcareassociatedinfectionsinneonatalintensivecareunitsinturkeyamulticenterpointprevalencestudy AT suleyigit theprevalenceanddiagnosticcriteriaofhealthcareassociatedinfectionsinneonatalintensivecareunitsinturkeyamulticenterpointprevalencestudy AT asumancoban theprevalenceanddiagnosticcriteriaofhealthcareassociatedinfectionsinneonatalintensivecareunitsinturkeyamulticenterpointprevalencestudy AT ayseecevit theprevalenceanddiagnosticcriteriaofhealthcareassociatedinfectionsinneonatalintensivecareunitsinturkeyamulticenterpointprevalencestudy AT yalcıncelik theprevalenceanddiagnosticcriteriaofhealthcareassociatedinfectionsinneonatalintensivecareunitsinturkeyamulticenterpointprevalencestudy AT feritkulalı theprevalenceanddiagnosticcriteriaofhealthcareassociatedinfectionsinneonatalintensivecareunitsinturkeyamulticenterpointprevalencestudy AT tugbabedirdemirdag prevalenceanddiagnosticcriteriaofhealthcareassociatedinfectionsinneonatalintensivecareunitsinturkeyamulticenterpointprevalencestudy AT esinkoc prevalenceanddiagnosticcriteriaofhealthcareassociatedinfectionsinneonatalintensivecareunitsinturkeyamulticenterpointprevalencestudy AT hasantezer prevalenceanddiagnosticcriteriaofhealthcareassociatedinfectionsinneonatalintensivecareunitsinturkeyamulticenterpointprevalencestudy AT sunaoguz prevalenceanddiagnosticcriteriaofhealthcareassociatedinfectionsinneonatalintensivecareunitsinturkeyamulticenterpointprevalencestudy AT mehmetsatar prevalenceanddiagnosticcriteriaofhealthcareassociatedinfectionsinneonatalintensivecareunitsinturkeyamulticenterpointprevalencestudy AT ozgesaglam prevalenceanddiagnosticcriteriaofhealthcareassociatedinfectionsinneonatalintensivecareunitsinturkeyamulticenterpointprevalencestudy AT saimesunduzuygun prevalenceanddiagnosticcriteriaofhealthcareassociatedinfectionsinneonatalintensivecareunitsinturkeyamulticenterpointprevalencestudy AT esraonal prevalenceanddiagnosticcriteriaofhealthcareassociatedinfectionsinneonatalintensivecareunitsinturkeyamulticenterpointprevalencestudy AT ibrahimmurathirfanoglu prevalenceanddiagnosticcriteriaofhealthcareassociatedinfectionsinneonatalintensivecareunitsinturkeyamulticenterpointprevalencestudy AT kadirtekgunduz prevalenceanddiagnosticcriteriaofhealthcareassociatedinfectionsinneonatalintensivecareunitsinturkeyamulticenterpointprevalencestudy AT nihaloygur prevalenceanddiagnosticcriteriaofhealthcareassociatedinfectionsinneonatalintensivecareunitsinturkeyamulticenterpointprevalencestudy AT alibulbul prevalenceanddiagnosticcriteriaofhealthcareassociatedinfectionsinneonatalintensivecareunitsinturkeyamulticenterpointprevalencestudy AT adilumutzubarioglu prevalenceanddiagnosticcriteriaofhealthcareassociatedinfectionsinneonatalintensivecareunitsinturkeyamulticenterpointprevalencestudy AT nuranustun prevalenceanddiagnosticcriteriaofhealthcareassociatedinfectionsinneonatalintensivecareunitsinturkeyamulticenterpointprevalencestudy AT sezinunal prevalenceanddiagnosticcriteriaofhealthcareassociatedinfectionsinneonatalintensivecareunitsinturkeyamulticenterpointprevalencestudy AT cananaygun prevalenceanddiagnosticcriteriaofhealthcareassociatedinfectionsinneonatalintensivecareunitsinturkeyamulticenterpointprevalencestudy AT belmasaygılıkaragol prevalenceanddiagnosticcriteriaofhealthcareassociatedinfectionsinneonatalintensivecareunitsinturkeyamulticenterpointprevalencestudy AT aysegulzenciroglu prevalenceanddiagnosticcriteriaofhealthcareassociatedinfectionsinneonatalintensivecareunitsinturkeyamulticenterpointprevalencestudy AT myektaoncel prevalenceanddiagnosticcriteriaofhealthcareassociatedinfectionsinneonatalintensivecareunitsinturkeyamulticenterpointprevalencestudy AT adviyecakılsaglık prevalenceanddiagnosticcriteriaofhealthcareassociatedinfectionsinneonatalintensivecareunitsinturkeyamulticenterpointprevalencestudy AT emelokulu prevalenceanddiagnosticcriteriaofhealthcareassociatedinfectionsinneonatalintensivecareunitsinturkeyamulticenterpointprevalencestudy AT demetterek prevalenceanddiagnosticcriteriaofhealthcareassociatedinfectionsinneonatalintensivecareunitsinturkeyamulticenterpointprevalencestudy AT nejatnarlı prevalenceanddiagnosticcriteriaofhealthcareassociatedinfectionsinneonatalintensivecareunitsinturkeyamulticenterpointprevalencestudy AT didemaliefendioglu prevalenceanddiagnosticcriteriaofhealthcareassociatedinfectionsinneonatalintensivecareunitsinturkeyamulticenterpointprevalencestudy AT tugbagursoy prevalenceanddiagnosticcriteriaofhealthcareassociatedinfectionsinneonatalintensivecareunitsinturkeyamulticenterpointprevalencestudy AT sevimunal prevalenceanddiagnosticcriteriaofhealthcareassociatedinfectionsinneonatalintensivecareunitsinturkeyamulticenterpointprevalencestudy AT munevverkaynakturkmen prevalenceanddiagnosticcriteriaofhealthcareassociatedinfectionsinneonatalintensivecareunitsinturkeyamulticenterpointprevalencestudy AT fatmakayanarter prevalenceanddiagnosticcriteriaofhealthcareassociatedinfectionsinneonatalintensivecareunitsinturkeyamulticenterpointprevalencestudy AT nukhetaladagciftdemir prevalenceanddiagnosticcriteriaofhealthcareassociatedinfectionsinneonatalintensivecareunitsinturkeyamulticenterpointprevalencestudy AT serdarbeken prevalenceanddiagnosticcriteriaofhealthcareassociatedinfectionsinneonatalintensivecareunitsinturkeyamulticenterpointprevalencestudy AT salihcagrıcakır prevalenceanddiagnosticcriteriaofhealthcareassociatedinfectionsinneonatalintensivecareunitsinturkeyamulticenterpointprevalencestudy AT suleyigit prevalenceanddiagnosticcriteriaofhealthcareassociatedinfectionsinneonatalintensivecareunitsinturkeyamulticenterpointprevalencestudy AT asumancoban prevalenceanddiagnosticcriteriaofhealthcareassociatedinfectionsinneonatalintensivecareunitsinturkeyamulticenterpointprevalencestudy AT ayseecevit prevalenceanddiagnosticcriteriaofhealthcareassociatedinfectionsinneonatalintensivecareunitsinturkeyamulticenterpointprevalencestudy AT yalcıncelik prevalenceanddiagnosticcriteriaofhealthcareassociatedinfectionsinneonatalintensivecareunitsinturkeyamulticenterpointprevalencestudy AT feritkulalı prevalenceanddiagnosticcriteriaofhealthcareassociatedinfectionsinneonatalintensivecareunitsinturkeyamulticenterpointprevalencestudy |