<?xml version="1.0" encoding="UTF-8"?>
<!DOCTYPE article PUBLIC "-//NLM//DTD JATS (Z39.96) Journal Publishing DTD v1.2d1 20170631//EN" "JATS-journalpublishing1.dtd">
<ArticleSet>
<Article>
<Journal>
<PublisherName>journal-jmsr</PublisherName>
<JournalTitle>Journal of Medical and Surgical Research</JournalTitle>
<PISSN>I</PISSN>
<EISSN>S</EISSN>
<Volume-Issue>Vol. XII, n 2</Volume-Issue>
<PartNumber/>
<IssueTopic>Multidisciplinary</IssueTopic>
<IssueLanguage>English</IssueLanguage>
<Season>December 2025</Season>
<SpecialIssue>N</SpecialIssue>
<SupplementaryIssue>N</SupplementaryIssue>
<IssueOA>Y</IssueOA>
<PubDate>
<Year>2025</Year>
<Month>12</Month>
<Day>31</Day>
</PubDate>
<ArticleType>JMSR Pediatrics</ArticleType>
<ArticleTitle>Healthcare-associated infections in neonatology Iin Morocco and Worldwide: a systematic review</ArticleTitle>
<SubTitle/>
<ArticleLanguage>English</ArticleLanguage>
<ArticleOA>Y</ArticleOA>
<FirstPage>1486</FirstPage>
<LastPage>1495</LastPage>
<AuthorList>
<Author>
<FirstName>Ikram Ben</FirstName>
<LastName>Bekkari</LastName>
<AuthorLanguage>English</AuthorLanguage>
<Affiliation/>
<CorrespondingAuthor>N</CorrespondingAuthor>
<ORCID/>
<FirstName>Amina</FirstName>
<LastName>Barkat</LastName>
<AuthorLanguage>English</AuthorLanguage>
<Affiliation/>
<CorrespondingAuthor>Y</CorrespondingAuthor>
<ORCID/>
</Author>
</AuthorList>
<DOI/>
<Abstract>Introduction: Healthcare-associated infections are a major public health concern, particularly in neonatology, were they contribute to significant morbidity and mortality. This review aims to describe the pathogens involved in healthcare-associated infections in neonatology and to assess their resistance to drugs.
Methods: the current study gathered data from reputable sources, employing a systematic review approach, including PubMed, Scopus and Google Scholar databases. We customized our search to include studies published from 2015 to 2024.
Results: of the 871 studies retrieved from the database. Twenty-seven studies were included. The overall prevalence of HAIs in neonatology ranged from 3.54% to 29%. Three infectious sites were predominant: bacteremia (21% to 91%), pneumonia (5.17% to 81.3%), and urinary tract infections (1.4% to 28.8%). The most frequently isolated pathogens were coagulase-negative Staphylococcus (27.86%), followed by Klebsiella spp (24.70%), Acinetobacter spp (13.75%), Pseudomonas spp (8.93%) and Staphylococcus aureus (6.27%). Multidrug-resistance bacteria were mainly represented by methicillin-resistance Staphylococcus aureus with rates ranging from 0% to 100%, extended spectrum beta-lactamase-producing Enterobacteriaceae, with rates ranging from 0% for Klebsiella isolates to 91.02%, and vancomycin-resistant Enterococcus, with rates ranged from 90% to 100%.
Conclusion: understanding the bacterial ecology and resistance profiles of neonatal healthcare-associated infections are crucial to reducing their incidence and guiding empirical antibiotic therapy. This systematic review recommends the rigorous application of hygiene measures throughout neonatal care and the reduction of the number and duration of invasive procedures to limit neonatal mortality caused by these infections.</Abstract>
<AbstractLanguage>English</AbstractLanguage>
<Keywords>Antibiotic resistance, associated infections, Infant, Neonatology, Newborn, Morocco</Keywords>
<URLs>
<Abstract>https://www.journal-jmsr.net/ubijournal-v1copy/journals/abstract.php?article_id=16147&title=Healthcare-associated infections in neonatology Iin Morocco and Worldwide: a systematic review</Abstract>
</URLs>
<References>
<ReferencesarticleTitle>References</ReferencesarticleTitle>
<ReferencesfirstPage>16</ReferencesfirstPage>
<ReferenceslastPage>19</ReferenceslastPage>
<References>Crivaro V, Bogdanoviand;#263; L, Bagattini M, Iula VD, Catania M, Raimondi F, Triassi M, Zarrilli R. Surveillance of healthcare-associated infections in a neonatal intensive care unit in Italy during 2006-2010. BMC Infect Dis. 2015 Mar 25;15:152. doi: 10.1186/s12879-015-0909-9. PMID: 25885702; PMCID: PMC4374496.
Horan TC, Andrus M, Dudeck MA. CDC/NHSN surveillance definition of health care-associated infection and criteria for specific types of infections in the acute care setting. Am J Infect Control. 2008 Jun;36(5):309-32. doi: 10.1016/j.ajic.2008.03.002. Erratum in: Am J Infect Control. 2008 Nov;36(9):655. PMID: 18538699.
Johnson J, Quach C. Outbreaks in the neonatal ICU: a review of the literature. Curr Opin Infect Dis. 2017 Aug;30(4):395-403. doi: 10.1097/QCO.0000000000000383. PMID: 28582313; PMCID: PMC8020806
Zingg W, Hopkins S, Gayet-Ageron A, Holmes A, Sharland M, Suetens C; ECDC PPS study group. Health-care-associated infections in neonates, children, and adolescents: an analysis of paediatric data from the European Centre for Disease Prevention and Control point-prevalence survey. Lancet Infect Dis. 2017 Apr;17(4):381-389. doi: 10.1016/S1473-3099(16)30517-5. Epub 2017 Jan 13. PMID: 28089444.
Babazono A, Kitajima H, Nishimaki S, Nakamura T, Shiga S, Hayakawa M, Tanaka T, Sato K, Nakayama H, Ibara S, Une H, Doi H. Risk factors for nosocomial infection in the neonatal intensive care unit by the Japanese Nosocomial Infection Surveillance (JANIS). Acta Med Okayama. 2008 Aug;62(4):261-8. doi: 10.18926/AMO/30938. PMID: 18766209.
Tand;aacute;vora AC, Castro AB, Militand;atilde;o MA, Girand;atilde;o JE, Ribeiro Kde C, Tand;aacute;vora LG. Risk factors for nosocomial infection in a Brazilian neonatal intensive care unit. Braz J Infect Dis. 2008 Feb;12(1):75-9. doi: 10.1590/s1413-86702008000100016. PMID: 18553019.
Gadallah MA, Aboul Fotouh AM, Habil IS, Imam SS, Wassef G. Surveillance of health care-associated infections in a tertiary hospital neonatal intensive care unit in Egypt: 1-year follow-up. Am J Infect Control. 2014 Nov;42(11):1207-11. doi: 10.1016/j.ajic.2014.07.020. Epub 2014 Sep 16. PMID: 25238664.
Polin RA, Denson S, Brady MT; Committee on Fetus and Newborn; Committee on Infectious Diseases. Epidemiology and diagnosis of health care-associated infections in the NICU. Pediatrics. 2012 Apr;129(4):e1104-9. doi: 10.1542/peds.2012-0147. Epub 2012 Mar 26. PMID: 22451708.
Xu J, Zhang Y, Ma H, Zhang R, Wu J. Analysis of Factors Related to Neonatal Infection and Monitoring of Bacterial Drug Resistance. Z Geburtshilfe Neonatol. 2022 Dec;226(6):399-404. doi: 10.1055/a-1850-2475. Epub 2022 Jul 4. PMID: 35785815; PMCID: PMC9731785.
AL-SELWI A. G., BARKAT A. Actions based on evidence to fight against neonatal mortality, international and national data: a meta-analysis. Chinese journal of otorhinolaryngology head and neck surgery. 2023 Nov; 54(09): 1155-1165.
Hattoufi K, Kharbach A, Barkat A. Infecciand;oacute;n bacteriana neonatal de inicio temprano con localizaciand;oacute;n menand;iacute;ngea: informe de 57 casos de reciand;eacute;n nacidos marroquand;iacute;es. Pand;eacute;rinatalitand;eacute;, 2021; 13(4):183-189. doi: 10.3166/rmp-2021-0136.
Rahmouni H. and;Eacute;tude prospective des bactand;eacute;ries impliquand;eacute;es dans land;rsquo;infection nosocomiale au service de rand;eacute;animation nand;eacute;onatale and;agrave; land;rsquo;hand;ocirc;pital dand;rsquo;enfants de Rabat [thand;egrave;se]. Rabat (Maroc) : Universitand;eacute; Mohammed V, Facultand;eacute; de Mand;eacute;decine et de Pharmacie de Rabat ; 2022. Disponible sur: https://toubkal.imist.ma/bitstream/handle/123456789/19195/P0172022.pdf?sequence=1
Abdellaoui C. Incidence et epidemiologie des infections nosocomiales en neonatologie [thand;egrave;se]. Rabat (Maroc) : Universitand;eacute; Mohammed V, Facultand;eacute; de Mand;eacute;decine et de Pharmacie de Rabat ; 2022. Disponible sur: https://toubkal.imist.ma/bitstream/handle/123456789/19181/P0032022.pdf?sequence=1
Bighoumdan K. Infections nosocomiales pand;eacute;riopand;eacute;ratoires chez les nouveau-nand;eacute;s en rand;eacute;animation pand;eacute;diatrique [thand;egrave;se]. Marrakech (Maroc) : Universitand;eacute; Cadi Ayyad, Facultand;eacute; de Mand;eacute;decine et de Pharmacie de Marrakech; 2020.Disponible sur: https://toubkal.imist.ma/handle/123456789/21547
Helyaich A, Slitine N.E. I., Bennaoui F, Soraa N , Maoulainine F. M. R. Bacterial Nosocomial Infection: Experience of the Neonatal Intensive Care Unit at the University Hospital of Marrakech. Open Infect Dis J. 2019 ; 11(1). doi: 10.2174/1874279301911010017
Benabbas D.R, Kara S. Etude rand;eacute;trospective sur les infections nosocomiales au niveau du service de nand;eacute;onatologie du CHU de Constantine [Mand;eacute;moire de master]. Constantine (Algand;eacute;rie): Universitand;eacute; Frand;egrave;res Mentouri Constantine 1, Facultand;eacute; des Sciences de la Nature et de la Vie, Dand;eacute;partement de Biologie Appliquand;eacute;e; 2019. Disponible sur: https://fac.umc.edu.dz/snv/bibliotheque/biblio/mmf/2019/Etude%20r%C3%A9trospective%20sur%20les%20infections%20nosocomiales%20au%20niveau%20du%20service%20de%20n%C3%A9onatologie%20du%20CHU%20de%20Constantine..pdf
Dand;rsquo;Almeida M, Bagnan L, Siland;eacute; SN, Djagoun E, Ouendo EM, Ayivi B, Bouali Rouvinez N. Infections nosocomiales. and;Eacute;tude rand;eacute;trospective de 45 cas and;agrave; land;rsquo;Unitand;eacute; de Nand;eacute;onatologie du Centre National Hospitalier et Universitaire de Cotonou. J Afr Pediatr Genet Med. 2017 ;(2):20-25.
Cura C, Ozen M, Akaslan Kara A, Alkan G, Sesli Cetin E. Health care-associated infection surveillance in a tertiary neonatal intensive care unit: A prospective clinical study after moving to a new building. Am J Infect Control. 2016 Jan 1;44(1):80-4. doi: 10.1016/j.ajic.2015.07.032. Epub 2015 Aug 29. PMID: 26320701.
Kajiyazdi M, Dasdar S, Kianfar N, Kaveh M.. Nosocomial Infection Surveillance in Neonatal Intensive Care Units of Bahrami Childrenand;rsquo;s Hospital. Arch Pediatr Infect Dis. 2021;9(3): e108840.doi: 10.5812/pedinfect.108840.
Rangelova V, Raycheva R, Kevorkyan A, Krasteva M, Dermendzhiev T. Surveillance of Nosocomial Infections in a Bulgarian Neonatal Intensive Care Unit. Folia Med (Plovdiv). 2020 Dec 31;62(4):753-761. doi: 10.3897/folmed.62.e50437. PMID: 33415917.
Torres-Muand;ntilde;oz J, Hoyos IV, Murillo J, Holguin J, Dand;aacute;valos D, Land;oacute;pez E, Torres-Figueroa S. Device-associated infections in neonatal care units in a middle-income country, 2016-2018. J Pediatr (Rio J). 2023 Sep-Oct;99(5):485-491. doi: 10.1016/j.jped.2023.03.004. Epub 2023 May 3. PMID: 37148912; PMCID: PMC10492145.
Peters L, Olson L, Khu DTK, Linnros S, Le NK, Hanberger H, Hoang NTB, Tran DM, Larsson M. Multiple antibiotic resistance as a risk factor for mortality and prolonged hospital stay: A cohort study among neonatal intensive care patients with hospital-acquired infections caused by gram-negative bacteria in Vietnam. PLoS One. 2019 May 8;14(5):e0215666. doi: 10.1371/journal.pone.0215666. PMID: 31067232; PMCID: PMC6505890.
Choobdar F, Vahedi Z, Khosravi N, Khalesi N, Javid A, et al. Nosocomial Infection in an Iranian Neonatal Intensive Care Unit: Hospital Epidemiology and Risk Factors.Arch Pediatr Infect Dis.2020;8(4):e96850.https://doi.org/10.5812/pedinfect.96850.
Kuissi KE, Mintoand;rsquo;o RS, Mimbila M, Medza ER, Koumba MR, et al. Epidemiological Aspects and Evolution of Nosocomial Infection in the Neonatology Unit of Angondje Teaching Hospital. Neonat Pediatr Med. 2019; 5: 182. Disponible sur: https://www.researchgate.net/publication/330564234_Neonatal_and_Pediatric_Medicine_Epidemiological_Aspects_and_Evolution_of_Nosocomial_Infection_in_the_Neonatology_Unit_of_Angondje_Teaching_Hospital?enrichId=rgreq-630ffad4dc1a195bfeb60af47ac91352-XXXand;enrichSource=Y292ZXJQYWdlOzMzMDU2NDIzNDtBUzo3ODQ2NTczMzU0NjM5MzZAMTU2NDA4ODI5NTE4NA%3D%3Dand;el=1_x_2and;_esc=publicationCoverPdf
Kilic A, Okulu E, Kocabas BA, Alan S, Cakir U, Yildiz D, Kahvecioglu D, Akin IM, Erdeve O, Arsan S, Ince E, Atasay B. Health care-associated infection surveillance: A prospective study of a tertiary neonatal intensive care unit. J Infect Dev Ctries. 2019 Mar 31;13(3):181-187. doi: 10.3855/jidc.10688. PMID: 32040446.
Ertugrul S, Aktar F, Yolbas I, Yilmaz A, Elbey B, Yildirim A, Yilmaz K, Tekin R. Risk Factors for Health Care-Associated Bloodstream Infections in a Neonatal Intensive Care Unit. Iran J Pediatr. 2016 Jul 27;26(5):e5213. doi: 10.5812/ijp.5213. PMID: 28203330; PMCID: PMC5297258.
Bukasa JC, Muteba P, Kazadi A, Lepelletier D, Ilunga F, Mutombo A, Kamanya AN, Bandimuna A, Mbo SN, Stany W. Etude de land;acute;incidence des infections nosocomiales et facteurs de risque dans les maternitand;eacute;s de la ville de Mbujimayi, Rand;eacute;publique Dand;eacute;mocratique du Congo [A study of the incidence of nosocomial infections and the associated risk factors in the city of Mbujimayi, Democratic Republic of Congo]. Pan Afr Med J. 2021 Jan 28;38:95. French. doi: 10.11604/pamj.2021.38.95.15044. PMID: 33889261; PMCID: PMC8035685.
Bedir Demirdaand;#287; T, Koand;ccedil; E, Tezer H, Oand;#287;uz S, Satar M, Saand;#287;lam and;Ouml;, Uygun SS, and;Ouml;nal E, Hirfanoand;#287;lu and;#304;M, Tekgand;uuml;ndand;uuml;z K, Oygand;uuml;r N, Band;uuml;lband;uuml;l A, Zand;uuml;barioand;#287;lu AU, and;Uuml;stand;uuml;n N, and;Uuml;nal S, Aygand;uuml;n C, Saygand;#305;land;#305; Karagand;ouml;l B, Zenciroand;#287;lu A, and;Ouml;ncel MY, and;Ccedil;akand;#305;l Saand;#287;land;#305;k A, Okulu E, Terek D, Narland;#305; N, Aliefendioand;#287;lu D, Gand;uuml;rsoy T, and;Uuml;nal S, Kaynak Tand;uuml;rkmen M, Kaya Narter F, Aladaand;#287; and;Ccedil;iftdemir N, Beken S, and;Ccedil;akand;#305;r Sand;Ccedil;, Yiand;#287;it and;#350;, and;Ccedil;oban A, Ecevit A, and;Ccedil;elik Y, Kulaland;#305; F. The prevalence and diagnostic criteria of health-care associated infections in neonatal intensive care units in Turkey: A multicenter point- prevalence study. Pediatr Neonatol. 2021 Mar;62(2):208-217. doi: 10.1016/j.pedneo.2021.01.001. Epub 2021 Jan 19. PMID: 33546932.
Crivaro V, Bogdanoviand;#263; L, Bagattini M, Iula VD, Catania M, Raimondi F, Triassi M, Zarrilli R. Surveillance of healthcare-associated infections in a neonatal intensive care unit in Italy during 2006-2010. BMC Infect Dis. 2015 Mar 25;15:152. doi: 10.1186/s12879-015-0909-9. PMID: 25885702; PMCID: PMC4374496.
El-Feky EA, Saleh DA, El-Kholy J, Sayed AM, Mansi Y, Hashem M. Use of personal digital assistants to detect healthcare-associated infections in a neonatal intensive care unit in Egypt. J Infect Dev Ctries. 2016 Nov 24;10(11):1250-1257. doi: 10.3855/jidc.7789. PMID: 27886039.
Kartikeswar GAP, Parikh TB, Randive B, Kinikar A, Rajput UC, Valvi C, Vaidya U, Malwade S, Agarkhedkar S, Kadam A, Smith RM, Westercamp M, Schumacher C, Mave V, Robinson ML, Gupta A, Milstone AM, Manabe YC, Johnson J. Bloodstream infections in neonates with central venous catheters in three tertiary neonatal intensive care units in Pune, India. J Neonatal Perinatal Med. 2023;16(3):507-516. doi: 10.3233/NPM-221110. PMID: 37718859; PMCID: PMC10875914.
Chabah M, Chemsi M, Zerouali K, Alloula O, Lehlimi M, Habzi A, Benomar S. Healthcare-associated infections due to carbapenemase-producing Enterobacteriaceae: Bacteriological profile and risk factors. Med Mal Infect. 2016 May;46(3):157-62. doi: 10.1016/j.medmal.2015.12.015. Epub 2016 Feb 17. PMID: 26897308.
Scamardo MS, Dolce P, Esposito EP, Raimondi F, Triassi M, Zarrilli R. Trends, risk factors and outcomes of healthcare-associated infections in a neonatal intensive care unit in Italy during 2013-2017. Ital J Pediatr. 2020 Mar 18;46(1):34. doi: 10.1186/s13052-020-0799-3. PMID: 32183842; PMCID: PMC7079437.
Ceparano M, Sciurti A, Isonne C, Baccolini V, Migliara G, Marzuillo C, Natale F, Terrin G, Villari P, The Collaborating Group. Incidence of Healthcare-Associated Infections in a Neonatal Intensive Care Unit before and during the COVID-19 Pandemic: A Four-Year Retrospective Cohort Study. J Clin Med. 2023 Mar 30;12(7):2621. doi: 10.3390/jcm12072621. PMID: 37048704; PMCID: PMC10094878.
Garcand;iacute;a H, Torres-Gutiand;eacute;rrez J, Peregrino-Bejarano L, Cruz-Castaand;ntilde;eda MA. Factores de riesgo asociados a infecciand;oacute;n nosocomial (IN) en una Unidad de Cuidados Intensivos Neonatales (UCIN) de tercer nivel [Risk factors for nosocomial infection in a level III Neonatal Intensive Care Unit]. Gac Med Mex. 2015 Nov-Dec;151(6):711-9. Spanish. PMID: 26581528.
Verstraete EH, Mahieu L, De Coen K, Vogelaers D, Blot S. Impact of healthcare-associated sepsis on mortality in critically ill infants. Eur J Pediatr. 2016 Jul;175(7):943-52. doi: 10.1007/s00431-016-2726-6. Epub 2016 Apr 27. PMID: 27118596.
Garcand;iacute;a H, Miranda-Novales G, Lorenzo-Hernand;aacute;ndez LM, Luna AT. Risk factors for healthcare-associated infections in newborns after surgery in a neonatal intensive care unit. Gac Med Mex. 2023;159(2):96-102. English. doi: 10.24875/GMM.22000270. PMID: 37094234.
Ramanampamonjy MTM, Rasamoelison RJ, Samena HSC, Rambeloson SH, Rahajamanana VL, Robinson AL. Facteurs de risque de bactand;eacute;riand;eacute;mie nosocomiale nand;eacute;onatale au Centre Hospitalier Universitaire Mand;egrave;reand;ndash;Enfant Tsaralalana, Antananarivo, Madagascar. Rev Anesth Reanim Med Urg Toxicol. 2022;14(2):1-5.
Hmamouchi B, Chakkouri K, Nejmi SE, Chlilek A. and;Eacute;pidand;eacute;miologie de land;#39;infection nosocomiale en rand;eacute;animation pand;eacute;diatrique. Ann Fr Anesth Reanim. 2005;24(6):699-700. doi:10.1016/j.annfar.2005.04.011
Maoulainine FM, Elidrissi NS, Chkil G, Abba F, Soraa N, Chabaa L, Amine M, Aboussad A. and;Eacute;pidand;eacute;miologie de land;#39;infection nosocomiale bactand;eacute;rienne dans un service de rand;eacute;animation nand;eacute;onatale marocain [Epidemiology of nosocomial bacterial infection in a neonatal intensive care unit in Morocco]. Arch Pediatr. 2014 Sep;21(9):938-43. French. doi: 10.1016/j.arcped.2014.04.033. Epub 2014 Jun 30. PMID: 24993147.
Sarvikivi E, Kand;auml;rki T, Lyytikand;auml;inen O; Finnish NICU Prevalence Study Group. Repeated prevalence surveys of healthcare-associated infections in Finnish neonatal intensive care units. J Hosp Infect. 2010 Oct;76(2):156-60. doi: 10.1016/j.jhin.2010.03.020. Epub 2010 Jun 25. PMID: 20579770.
Zoukal S, Tsoumbou-Bakana G, Traore B, Nani S, Hassoune S. Infections associand;eacute;es aux soins en nand;eacute;onatalogie dans la rand;eacute;gion du grand Maghreb. Revue systand;eacute;matique et mand;eacute;ta-analyse [Neonatal healthcare associated-infections in the Maghreb. A systematic review and meta-analysis]. Rev Epidemiol Sante Publique. 2021 Apr;69(2):88-95. French. doi: 10.1016/j.respe.2021.01.007. Epub 2021 Feb 25. PMID: 33642130.
de Mello Freitas FT, Viegas APB, Romero GAS. Neonatal healthcare-associated infections in Brazil: systematic review and meta-analysis. Arch Public Health. 2021; 79(1):89. 10.1186/s13690-021-00611-6</References>
</References>
</Journal>
</Article>
</ArticleSet>