| Combined use of alcohol hand rub and gloves reduces the incidence of late onset infection in very low birthweight infants. | |
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MedLine Citation:
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PMID: 15210670 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To assess the incidence of late onset (> 72 hours) infection and necrotising enterocolitis (NEC) in very low birthweight (VLBW) infants in two 36 month periods using two hand hygiene protocols: conventional handwashing (HW; first 36 month period); an alcohol hand rub and gloves technique (HR; second 36 month period). METHOD: VLBW infants admitted to the neonatal intensive care unit during the period December 1993-November 1999 were eligible. A new hand hygiene protocol using alcohol handrub and gloves was introduced in December 1996. Each patient's case record was reviewed retrospectively by two independent investigators using a standard data collection form. The incidence of NEC and systemic infections, including bacterial or fungal septicaemia, meningitis, and peritonitis, in the two periods were compared. RESULTS: The HW and HR groups contained 161 and 176 VLBW infants respectively. The incidence of late onset systemic infection decreased from 13.5 to 4.8 episodes (including NEC)/1000 patient days after introduction of the HR regimen, representing a 2.8-fold reduction. Similarly, the incidence of Gram positive, Gram negative, and fungal infections decreased 2.5-fold, 2.6-fold, and 7-fold respectively. There was also a significant reduction in the incidence of NEC in the HR group (p < 0.0001). Subgroup analysis revealed that the incidence of methicillin resistant Staphylococcus aureus (MRSA) septicaemia was significantly decreased in the second 36 month period (p = 0.048). The clinical data suggest that infants in the HW group had significantly earlier onset of sepsis (p < 0.05) and required oxygen supplementation for longer (p < 0.05) than those in the HR group. Significantly more VLBW infants were discharged from the neonatal intensive care unit without ever being infected (p < 0.0001), and also significantly fewer infants had more than one episode of infection in the HR group (p < 0.0001). CONCLUSION: The introduction of the HR protocol was associated with a 2.8-fold reduction in the incidence of late onset systemic infection, and also a significant decrease in the incidence of MRSA septicaemia and NEC in VLBW infants. This decrease in infection rate was maintained throughout the second 36 month period. |
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Authors:
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P C Ng; H L Wong; D J Lyon; K W So; F Liu; R K Y Lam; E Wong; A F B Cheng; T F Fok |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Archives of disease in childhood. Fetal and neonatal edition Volume: 89 ISSN: 1359-2998 ISO Abbreviation: Arch. Dis. Child. Fetal Neonatal Ed. Publication Date: 2004 Jul |
Date Detail:
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Created Date: 2004-06-22 Completed Date: 2004-07-19 Revised Date: 2009-11-18 |
Medline Journal Info:
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Nlm Unique ID: 9501297 Medline TA: Arch Dis Child Fetal Neonatal Ed Country: England |
Other Details:
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Languages: eng Pagination: F336-40 Citation Subset: AIM; IM |
Affiliation:
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Level 6, Clinical Sciences Building, Prince of Wales Hospital, Shatin, NT, Hong Kong. pakcheungng@cuhk.edu.hk |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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2-Propanol* Administration, Topical Anti-Infective Agents, Local Combined Modality Therapy Cross Infection / prevention & control* Enterocolitis, Necrotizing / prevention & control* Ethanol* Female Gloves, Protective* Handwashing Humans Hygiene Infant, Newborn Infant, Premature, Diseases / prevention & control* Infant, Very Low Birth Weight* Infection Control / methods* Male Retrospective Studies |
| Chemical | |
Reg. No./Substance:
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0/Anti-Infective Agents, Local; 64-17-5/Ethanol; 67-63-0/2-Propanol |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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