|
|
||||||||||||||
|
|
|||||||||||||||
ORIGINAL ARTICLE |
1 Department of Paediatrics, Prince of Wales Hospital, The Chinese University of Hong Kong
2 Department of Microbiology, Prince of Wales Hospital
3 Centre for Clinical Trials and Epidemiological Research, Prince of Wales Hospital
Correspondence to:
Correspondence to:
Professor Ng
Department of Paediatrics, Level 6, Clinical Sciences Building, Prince of Wales Hospital, Shatin, NT, Hong Kong; pakcheungng{at}cuhk.edu.hk
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 1993November 1999 were eligible. A new hand hygiene protocol using alcohol handrub and gloves was introduced in December 1996. Each patients 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.
Abbreviations: BPD, bronchopulmonary dysplasia; MRSA, methicillin resistant Staphylococcus aureus; NEC, necrotising enterocolitis; NICU, neonatal intensive care unit; VLBW, very low birthweight
Keywords: alcohol hand rub; gloves; late onset infection; preterm infants
This article has been cited by other articles:
![]() |
K. W. So and P. C. Ng International Perspectives: Neonatology in Hong Kong: 10 Years After the Return of Sovereignty to China NeoReviews, December 1, 2007; 8(12): e513 - e521. [Full Text] [PDF] |
||||
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS | REGISTER |
| ARCH DIS CHILD | FETAL NEONATAL ED | ED PRACTICE |