5, 7 and 8 The variables were collected through active search in records by a qualified and trained HICC professional and were recorded in the Epidemiology Center database of the aforementioned commission. The sample included all neonates at risk admitted at the NPCU, considering NHSN criteria7 and/or ANVISA criteria8 for HAI reporting. Patient data and HAI notifications were entered in a computer software (Microsoft Excel, 2003, USA) spreadsheet and analyzed using the SPSS software

(release 13.0, 2008, USA). Statistical analysis included calculation of incidence density (ID) of infections Selleckchem XL184 (number of infections per 1,000 patient‐days), distribution of HAIs by weight range, and by surveillance criteria and notification. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated for the criteria proposed by ANVISA8 considering the criteria established by NHSN7 as the gold standard for the total number of HAIs, and an exclusive analysis for reported sepsis cases, as they represent the majority of infections in which only one of the criteria was used for HAI notification. The analysis of agreement between the methods was used to measure the kappa index, which is based on the number of concordant responses beyond what would be expected by chance.9 Kappa ranges from ‐1 (total absence of agreement) to

+1 (complete agreement). Kappa values above 0.75 are considered as excellent agreement; between 0.4 and 0.75 as good, and below 0.4, the agreement is considered weak. The project was approved 3Methyladenine by the Research Ethics Committee of HC/UFMG, according to COEP: ETIC 312/08. There were no procedures that could interfere with the healthcare activities and routines of the NPCU of HC/UFMG. A total of 882 patients were admitted at the NPCU, totaling 19,137 patient‐days, and 330 newborns had at least one episode of infection reported by at least one of the criteria. A total of 522 episodes of HAIs were reported regardless of the criteria, find more with incidence

density (ID) of 27.28 infections/1,000 patient‐days. Of the patients followed by the epidemiological surveillance (n = 882), 73.8% were in the weight range > 1,501 g; however, the ID and the percentage of patients with HAIs were more elevated in the weight range < 750 g when compared to the others (p < 0.001). The total number of patients, number of HAIs, and incidence density are presented by weight range in Table 1. A total of 522 notifications of HAIs in 17 different topographies were filled, regardless of the surveillance criteria used. Sepsis was the most frequent infectious complication, with 305 cases (58.3%), of which 122 (40%) were early‐onset and 183 (60%) were late‐onset cases. Clinical sepsis (n = 197) corresponded to 37.7% of total reported infections, and sepsis with laboratory confirmation (n = 108) to 20.6% of the total HAIs, regardless of the criteria used.