Epidemiology, microbiological characteristics, and antimicrobial resistance of device-associated healthcare-associated infections in a neonatal intensive care unit: a six-year surveillance study

Background Device-associated healthcare-associated infections (DA-HAIs) remain an important concern in neonatal intensive care units (NICUs). This study describes six-year surveillance data on the epidemiology, device utilization, pathogen distribution, and antimicrobial resistance of DA-HAIs. Methods We conducted a retrospective descriptive surveillance study from 2020 to 2025. Ventilator-associated pneumonia (VAP), central line-associated bloodstream infection (CLABSI), and catheter-associated urinary tract infection (CAUTI) were classified using a standardized CDC/NHSN surveillance framework. Annual infection rates per 1,000 device-days, exact 95% confidence intervals (CIs), device utilization ratios, and isolate-level microbiological data were summarized. Results Twenty-four CLABSI episodes occurred during 17,033 central-line days (1.41 per 1,000 line-days; 95% CI, 0.90–2.10), and 46 VAP episodes occurred during 21,628 ventilator-days (2.13 per 1,000 ventilator-days; 95% CI, 1.56–2.84). No CAUTI episodes occurred during 2,294 urinary catheter-days (95% CI, 0.00–1.61 per 1,000 catheter-days). Coagulase-negative staphylococci predominated among CLABSI isolates. Gram-negative organisms accounted for 25 of 42 recorded VAP isolates, while Staphylococcus haemolyticus was the single most common VAP isolate. MDR classifications varied by organism. Conclusion These surveillance data characterize local DA-HAI patterns and support continued attention to device stewardship, microbiological surveillance, and antimicrobial stewardship.