Background

The influence of the neonatal intensive care unit (NICU) design on the acquisition of multidrug resistant organisms (MDRO) has not been well-documented. The aim of this study was to examine the effect of open bay unit (OBU) versus single room unit (SRU) design on the incidence of colonization and infection with MDRO and third generation cephalosporin resistant bacteria (3G-CRB) as well as the number of possible transmission events in infants admitted to the NICU.

Methods

All infants admitted to the NICU two years prior to and two years following transition from OBU to SRU were identified. Incidence of colonization, infection and possible transmission events of MDRO were compared between OBU and SRU periods.

Results

Analysis was performed in 1293 NICU infants, which identified 3.2% MDRO carriers including 2.3% extended-spectrum β-lactamase producing Enterobacterales carriers and 18.6% 3G-CRB carriers.

No difference was found in the incidence density per 1,000 patient-days (1.56 OBU, 2.63 SRU, n.s.) between the historic open ward and the new single room units. The MDRO infection rate was low (0.12%) and not found to be different between OBU and SRU infants. We did not find a decrease in possible transmission events per 1,000 patient-days after transition (0.62 OBU, 0.81 SRU, n.s.).

Conclusions

Transition from an open bay to a single room unit NICU was not associated with a reduction in colonization and infection rates or possible transmission events with MDRO in our hospital.