Despite current prevention efforts, outbreaks of healthcare-associated infections in
neonatal units remain high globally, with a considerable burden of mortality and
morbidity. We searched Medline, Cochrane Library and www.outbreak-database.com
to identify studies of neonatal healthcare-associated outbreaks between 2005 and
2015 that described interventions to control outbreaks. All studies were evaluated
using the ORION guidance. 30 studies were identified including 17,102 infants of
which 664 (3.9%) became infected. No single intervention was identified that reduced
duration or mortality. Studies that introduced multiple interventions had significantly
reduced CFR and outbreak duration compared to those that used basic surveillance
only. Low and low-middle income countries reported the fewest interventions to
control outbreaks and these studies were also associated with higher mortality than
that found in middle and high-income countries. Systematic reporting and formal
evaluation of interventions used to reduce health-care-associated neonatal infection
outbreaks is key to identifying containment strategies worldwide.