Lucy Letby has been accused of murdering 5 baby boys & 2 girls & attempting to murder 10 other babies at Countess of Chester hospital.
Nick Johnson KC, prosecuting, said she was a "constant malevolent presence" in the hospital's neonatal unit.
Ms Letby, 32, denies 22 charges at Manchester Crown Court.
Jurors heard Ms Letby is alleged to have tried to kill 1 child 3 times, while another died as a result of being injected with air.
"Prior to January 2015, the statistics for the mortality of babies in the neo-natal unit at the Countess of Chester were comparable to other like units," he said.
"However, over the next 18 months or so, there was a significant rise in the number of babies who were dying & in the number of serious catastrophic collapses."
Medics also noted that babies who had collapsed "did not respond to appropriate & timely resuscitation" & that others "collapsed dramatically, but then, equally dramatically, recovered".
"Having searched for a cause, which they were unable to find, the consultants noticed that the inexplicable collapses & deaths did have one common denominator," he said.
"The presence of one of the neonatal nurses & that nurse was Lucy Letby."
"That review suggests in the period between mid-2015 & the middle of 2016, somebody in the neonatal unit poisoned 2 children with insulin," he said.
"The prosecution say the only reasonable conclusion to be drawn from the evidence you will hear is that somebody poisoned these babies deliberately with insulin."
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Source: BBC
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