Nationales Referenzzentrum
für Surveillance
von nosokomialen Infektionen


Module Summary

Module: NEO-KISS

Surveillance goal: Infection surveillance (plus optional antibiotic usage surveillance)

Surveillance principle: Ward-based

Patient group: Very low birthweight (<1500g) preterm infants

End of surveillance: Weight > 1800 g, death, discharge


The most important healthcare-associated infections for neonatal wards are recorded in NEO-KISS. These are necrotizing entercolitis (NEC), primary bloodstream infection (BSI) and pneumonia. During analysis, device usage (CVC, PVC, intubation, CPAP) is taken into account. It is also possible to consider antibiotic usage days.

If a neonatal ward would like to perform pathogen surveillance, it is possible to participate in ITS-KISS as part of STATIONS-KISS. Pediatric wards can participate in surveillance in the same way.

NEO-KISS (Nosocomial infection surveillance system for preterm infants on neonatology departments and ICUs)

Infection is one of the most important reasons for neonatal morbidity and mortality worldwide. Progress in neonatal intensive care has made it possible to decrease mortality among preterm infants with very low birth weights, but these preterm infants are at especially high risk for developing nosocomial infections. Surveillance has proven itself to be an effective method for reducing the frequency of nosocomial infections. An important part of the surveillance system is the comparison of infection rates. Nationwide reference data are necessary for comparing infection rates and for evaluating the efficiency of preventative measures. The goal of the project is to make nationwide reference data about the frequency of nosocomial infections among preterm infants more available. A pilot project was started in May 1999. Data collection on a patient-by-patient basis has been underway since January 2000. All children with a birthweight (BW) of less than 1500 g are included until their hospital discharge, death or weight of over 1800 g. Specially developed definitions are used for the diagnosis of the three kinds of infections tracked: pneumonia, primary bloodstream infections, and necrotizing enterocolitis. Stratified incidence density (infections/1000 patient-days) and device-related infection rates per 1000 device-days are calculated by BW class (less than 500 g, 501-999 g, and 1000 to 1499 g).

Data collected for NEO-KISS are put into webKess decentrally by the participants, where they are immediately available for evaluation. New reference data are calculated once per year from webKess data.

A requirement for participation in NEO-KISS in the completion of a course run by NRZ introducing KISS methods in detail and training the usage of fixed definitions in diagnosis.


Geffers C, Gastmeier P, Schwab F, Groneberg K, Rüden H, Gastmeier P.
Use of central venous catheter and peripheral venous catheter as risk factors for nosocomial bloodstream infection in very-low-birth-weight infants.
Infection Control and Hospital Epidemilogy 2010; 31(4): 395-401.

Geffers C, Bärwolff S, Schwab F, Gastmeier P.
Incidence of healthcare-associated infections in high-risk neonates: results from the German surveillance system for very low birth weight infants.
J Hosp Infect 2008; 68: 214-21.

Schwab F, Geffers C, Bärwolff S, Rüden M, Gastmeier P.
Reducing neonatal nosocomial bloodstream infections through participation in a national surveillance system.
J Hosp Infect 2007; 65: 319-25.

Bartels D, Schwab F, Geffers C, Poets C, Gastmeier P.
Nosocomial infection in small for gestational age newborns with birthweight < 1500g: a multicentre analysis.
Arch Dis Child Fetal Neonatal Ed. 2007; 92: F449-53.