Hospital-Acquired Infections in the NICU: Epidemiology for the New Millennium

Carey, Alison J.; Saiman, Lisa; Polin, Richard A.

doi:10.1016/j.clp.2007.11.014

Cited by 83 publications

(75 citation statements)

References 105 publications

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“…[1][2][3] Such high infection-related mortality mandates are an urgent implementation of simple and effective measures to prevent and/or reduce the occurrence of infections in these units.…”

Section: Introductionmentioning

confidence: 99%

Does skin cleansing with chlorhexidine affect skin condition, temperature and colonization in hospitalized preterm low birth weight infants?: a randomized clinical trial

et al. 2009

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Objective: To examine if single skin cleansing with 0.25% chlorhexidine affects skin condition, temperature and bacterial colonization in stable preterm (28-36 weeks gestational age) low birth weight (1001-2000 g) infants admitted in a health facility.Methods: Eligible infants were randomized within 3 h of birth into the following three groups: chlorhexidine, normal saline or no skin cleansing. Infants in the first two groups were wiped once with baby wipes containing either 0.25% chlorhexidine or saline. Skin condition, axillary temperature and skin colonization rates in the axilla and the groin were assessed at specified time intervals after intervention.Results: In all, 60 infants were included in the study (20 in each group). Median skin condition scores at 72 and 168 h after the intervention were 2 and 2, respectively, in all three groups. At 30 min after skin cleansing, two infants each in the chlorhexidine and saline cleansing groups and none in the no cleansing group experienced cold stress (36-36.4 1C). There was, however, no difference in mean skin temperature of the groups (36.6 1C). At 24 h, skin colonization rates in the axilla were 22.2, 52.7, and 57.9%, respectively, in the chlorhexidine, saline and no cleansing groups (P ¼ 0.06); skin cleansing with chlorhexidine reduced the incidence of colonization by 62% compared with no cleansing (relative risk (RR): 0.38, 95% confidence interval (CI): 0.15, 0.98), but there was no significant reduction when compared with saline cleansing (RR: 0.42; 0.16-1.10). Axillary colonization rates at 72 h and colonization at the groin at 24 and 72 h were not significantly different across the three groups.Conclusion: Single skin cleansing with 0.25% chlorhexidine did not adversely affect skin condition or temperature in hospitalized preterm infants and reduced axillary-skin colonization at 24 h after the intervention. Trials are needed to evaluate the efficacy of such an intervention on the incidence of infections in preterm neonates.

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Section: Introductionmentioning

confidence: 99%

Does skin cleansing with chlorhexidine affect skin condition, temperature and colonization in hospitalized preterm low birth weight infants?: a randomized clinical trial

et al. 2009

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“…(14-17) Twenty-fi ve of forty-eight (52.1%) colonized patients carried C.albicans and 15/48 (31.25%) C.parapsilosis. Th e rate of C.parapsilosis colonization is modestly higher than data reported in other paediatric units (2,18,19), so it could be considered an important and distinctive feature of our NICU, requiring deeper analysis. We identifi ed as risk factors for Candida spp.…”

Section: Discussionmentioning

confidence: 39%

“…has grown appreciably over the past years. (19) In this context, we underline the effectiveness of a microbiological surveillance plan. It is important to define the local epidemiology and to monitor rapid changes in the rates of infection, potential risk factors, and emerging pathogen species.…”

Section: Discussionmentioning

confidence: 99%

The burden of Candida species colonization in NICU patients: a colonization surveillance study

2017

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Fungal infections are an important cause of morbidity and mortality in neonatal intensive care units (NICUs). The identification of specific risk factors supports prevention of candidemia in neonates. Effective prophylactic strategies have recently become available, but the identification and adequate management of high-risk infants is still a priority. Prior colonization is a key risk factor for candidemia. For this reason, surveillance studies to monitor incidence, species distribution, and antifungal susceptibility profiles, are mandatory. Among 520 infants admitted to our NICU between January 2013 and December 2014, 472 (90.77%) were included in the study. Forty-eight out of 472 (10.17%) patients tested positive for Candida spp. (C.), at least on one occasion. All the colonized patients tested positive for the rectal swab, whereas 7 patients also tested positive for the nasal swab. Fifteen out of 472 patients (3.18%) had more than one positive rectal or nasal swab during their NICU stay. Moreover, 9 out of 15 patients tested negative at the first sampling, suggesting they acquired Candida spp. during their stay. Twenty-five of forty-eight (52.1%) colonized patients carried C.albicans and 15/48 (31.25%) C.parapsilosis. We identified as risk factors for Candida spp. colonization: antibiotic therapy, parenteral nutrition, the use of a central venous catheter, and nasogastric tube. Our experience suggests that effective microbiological surveillance can allow for implementing proper, effective and timely control measures in a highrisk setting.

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“…Entretanto, além das mãos, a colonização de outros sítios anatômicos por agentes infecciosos também contribui para a transmissão cruzada de patógenos (3,(7)(8)(9) . (6,(14)(15) .…”

Section: Introductionunclassified

“…Neste contexto, compreender a dinâmica da colonização por BGN é um desafio, uma vez que, estes micro-organismos estão frequentemente associados a surtos de infecção envolvendo cuidados assistenciais em saúde (15)(16) . A adesão às medidas de precaução padrão por trabalhadores de saúde destaca-se como estratégia primordial para o controle dos agravos, assegurando a qualidade da assistência prestada ao cliente, bem como a integridade do profissional (2,13) .…”

Section: Introductionunclassified

Prevalência de bastonetes Gram-negativos isolados da saliva de trabalhadores da saúde

et al. 2011

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Hospital-Acquired Infections in the NICU: Epidemiology for the New Millennium

Cited by 83 publications

References 105 publications

Does skin cleansing with chlorhexidine affect skin condition, temperature and colonization in hospitalized preterm low birth weight infants?: a randomized clinical trial

Does skin cleansing with chlorhexidine affect skin condition, temperature and colonization in hospitalized preterm low birth weight infants?: a randomized clinical trial

The burden of Candida species colonization in NICU patients: a colonization surveillance study

Prevalência de bastonetes Gram-negativos isolados da saliva de trabalhadores da saúde

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