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 crucial for guiding 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. 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 (30/39, 76.9% response rate) from all 13 cities ultimately participated and completed the survey. 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 had a significantly higher risk (RR = 17.0, 95% CI: 14.0–20.8; p < 0.001). Multivariable linear regression at the hospital level identified the proportion of neonates with birth weight < 1500 g as the sole independent factor associated with HAI rates (β = 0.062, p = 0.016), while infection preventionist staffing levels showed no significant association. The most common infection sites were bloodstream (44.1%), lower respiratory tract (17.4%), 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. This first province-wide study reveals a relatively low overall period prevalence of HAI among neonates in Jiangsu. The findings underscore that the proportion of very low birth weight neonates is a key driver of inter-hospital variation in infection rates. Prevention priorities should, therefore, focus on this high-risk population and on the predominant infection sites, particularly bloodstream infections. These efforts should be supported by strengthening microbiological surveillance.
Liu et al. (Sat,) studied this question.