Impact of Compliance with Infection Control Protocols on Infections in Neonatal Intensive Care Units: Review Article

Background: Neonatal Intensive Care Units (NICUs) care for the most vulnerable patient population, premature and critically-ill neonates, who are highly susceptible to healthcare-associated infections (HAIs). These infections represent a major cause of morbidity, mortality, and increased healthcare costs. Over the past decades, infection prevention and control (IPC) guidelines issued by international bodies such as the World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC) have been emphasized as essential strategies to mitigate these risks.
Objective: This review aimed to critically analyze the current evidence regarding adherence to infection control guidelines in NICUs and its impact on infection prevalence, patient outcomes, and healthcare system burden.
Methods: We searched PubMed, Google Scholar, and Science Direct for the epidemiology of NICU-related infections, common pathogens and the effectiveness of IPC measures such as hand hygiene, personal protective equipment (PPE), device-associated infection bundles, antimicrobial stewardship, and staff training programs. A narrative literature review was conducted using peer-reviewed studies, systematic reviews, and global surveillance reports published in recent years. Evidence was synthesized to highlight The writers evaluated relevant literature references as well. Documents written in languages other than English have been ignored. Papers that were not regarded as significant scientific research included dissertations, oral presentations, conference abstracts, and unpublished manuscripts were excluded.
Conclusion:Evidence consistently demonstrated that strict adherence to infection control protocols significantly reduced the incidence of bloodstream infections, ventilator-associated pneumonia and urinary tract infections in NICUs. Units with strong compliance to IPC guidelines report up to a 40–50% reduction in HAIs, improved neonatal survival, decreased antimicrobial resistance, and shortened hospital stays. Conversely, poor adherence is linked to higher infection rates, antimicrobial resistance, prolonged hospitalization, and increased economic burden. The literature strongly supports that adherence to IPC guidelines, which is a cornerstone of neonatal care. Effective implementation requires continuous staff education, adequate nurse-to-patient ratios, rigorous auditing and feedback systems, and integration of antimicrobial stewardship programs. Sustained compliance not only enhances neonatal safety and survival but also alleviates the financial and emotional burden on healthcare systems and families.