Document Detail


Combined use of alcohol hand rub and gloves reduces the incidence of late onset infection in very low birthweight infants.
MedLine Citation:
PMID:  15210670     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
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:
Type:  Journal Article    
Journal Detail:
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:
Created Date:  2004-06-22     Completed Date:  2004-07-19     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  9501297     Medline TA:  Arch Dis Child Fetal Neonatal Ed     Country:  England    
Other Details:
Languages:  eng     Pagination:  F336-40     Citation Subset:  AIM; IM    
Affiliation:
Level 6, Clinical Sciences Building, Prince of Wales Hospital, Shatin, NT, Hong Kong. pakcheungng@cuhk.edu.hk
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MeSH Terms
Descriptor/Qualifier:
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:
0/Anti-Infective Agents, Local; 64-17-5/Ethanol; 67-63-0/2-Propanol
Comments/Corrections

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