primary outcome:
Infant isolation and cohorting for preventing or reducing transmission of healthcare‐associated infections in neonatal units
Infection rate ‐ presented as number of infections per 1000 patient days.Colonization rate ‐ presented as number of colonizations per 1000 patient days.HAIs: infections people acquire within a healthcare setting that were not present or incubating at the time of admission. These include perinatally‐acquired infections in hospitalized neonates (Monegro 2023).Bloodstream infections (BSI): microbiologically confirmed bloodstream infection (bacterial or fungal) with growth in blood cultures; or tests positive according to a molecular test e.g. polymerase chain reaction, evaluated during hospital stay. Meningitis: microbiologically confirmed meningitis (bacterial or fungal) with detection of the pathogen in cerebrospinal fluid cultures or tests positive according to a molecular test e.g. polymerase chain reaction, evaluated during hospital stay.Urinary tract infection (UTI): diagnosis based on positive culture from a urine specimen collected by catheterization or suprapubic aspiration (urine collected in sterile bags has a high rate of false positives and hence is not recommended). Any growth in a suprapubic aspirate specimen (one colony is equivalent to 1000 CFU/mL) and a colony count of more than 50,000 CFU/mL or between 10,000 to 50,000 CFU/mL with associated pyuria will be defined as UTI (Donough 2023).Skin and soft tissue infections (SSI) as defined by the CDC: ''Infection occurs within 30 days after any operative procedure AND involves only skin and subcutaneous tissue of the incision AND patient has at least one of the following: Purulent drainage from the superficial incision;Organisms isolated from an aseptically obtained culture of fluid or tissue from the superficial incision;At least one of the following signs or symptoms of infection: pain or tenderness, localized swelling, redness, or heat, and superficial incision is deliberately opened by surgeon, unless incision is culture‐negative;Diagnosis of superficial incisional SSI by the surgeon or attending physician" (Ranji 2007).Ventilator‐associated pneumonia (VAP) defined by CDC 2022 and using a combination of imaging, clinical and laboratory criteria: ''Worsening gas exchange (for example, O2 desaturations...increased oxygen requirements, or increased ventilator demand)AND at least three of the following: Temperature instability;Leukopenia (≤ 4000 WBC/mm3) or leukocytosis (> 15,000 WBC/mm³) and left shift (> 10% band forms);Apnea, tachypnea5, nasal flaring with retraction of chest wall, or nasal flaring with grunting;Wheezing, rales, or rhonchi;Cough;Bradycardia (< 100 beats/min) or tachycardia (> 170 beats/min)" (CDC NHSN 2023).Central line‐associated BSI (CLABSI) defined by the CDC as a laboratory‐confirmed bloodstream infection (LCBI) where the central line (CL) or umbilical catheter (UC) was in place for >2 calendar days on the date of event and the line was also in place on the date of event or the day before. If a CL or UC was in place for >2 calendar days and then removed, the date of event of the LCBI must be the day of discontinuation or the next day to be a CLABSI (NHSN CDC 2023).