Geoffrey Ikpeama, MD, MPH, CIC Lead Infection Prevention Consultant

St. Louis Children’s Hospital

St. Louis, MO

Revised Publication:
December 14, 2023
Original Publication:
October 2, 2014
Declarations of Conflicts of Interest:
  • Conflict of Interest statement: Geoffrey Ikpeama confirms not conflicts of interest.

Special thanks to Ashley Loyd, RN, BSN, CIC (Infection Prevention Manager, St. Louis Children's Hospital) for her assistance in the revision process. 

Additional thanks to the 2014 chapter authors: Nancy Mendicino, RN, MSN, CICICP Director

Christus Santa Rosa Health Care
San Antonio, TX

Gloria Morrell, RN, MS, MSN, CICNurse Consultant

Centers for Disease Control and Prevention
Atlanta, GA

Susanna Leal Hernandez, BSN, RN, CICInfection Preventionist

Children's Hospital of San Antonio
San Antonio, TX


Neonates, especially those in a neonatal intensive care unit (NICU), are at high risk for infection. Neonates are susceptible to infection by microorganisms that can be easily transmitted between neonates via caregiver hands or equipment. Sources of infection include contaminated patient care supplies, and infected personnel, family, and other visitors. The risk increases with decreased birth weight and/or gestational age, and with exposure to invasive procedures and indwelling devices. In a nursery for newborns, infections of the skin, mouth, and eye are most frequent; in a neonatal intensive care unit, BSIs predominate. Coagulase-negative StaphylococcusStaphylococcus aureusEnterococcus, bacteria in the Enterobacteriaceae family, and Candida are the most frequently isolated organisms. Methicillin-resistant S. aureus (MRSA) is a significant presence in neonatal intensive care units. Outbreaks of respiratory and gastrointestinal viral infections also occur. This chapter presents the essential elements of infection prevention in neonatal environments.