Article

Strategies for Prevention of Health Care-Associated Infections in the NICU

PEDIATRICS (Impact Factor: 5.3). 03/2012; 129(4):e1085-93. DOI: 10.1542/peds.2012-0145
Source: PubMed

ABSTRACT Health care-associated infections in the NICU result in increased morbidity and mortality, prolonged lengths of stay, and increased medical costs. Neonates are at high risk of acquiring health care-associated infections because of impaired host-defense mechanisms, limited amounts of protective endogenous flora on skin and mucosal surfaces at time of birth, reduced barrier function of their skin, use of invasive procedures and devices, and frequent exposure to broad-spectrum antibiotic agents. This clinical report reviews management and prevention of health care-associated infections in newborn infants.

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    • "The occurrence of catheter-related infections in the summer was consistent with the increased SA prevalence (colonization pressure), and slack catheter monitoring. Catheter-related infections are the most common health-care associated infections in NICUs [22,27,28]. The general strategy for their prevention is based on good practice recommendations concerning (i) insertion and maintenance of indwelling lines, (ii) administration of prophylactic antibiotics e.g.: antibiotic lock therapy, (iii) use of skin emollients to reduce bacterial penetration, and (iv) health-care workers and visitors donning of single-use gowns [22]. "
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    07/2014; 3(1):21. DOI:10.1186/2047-2994-3-21
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    • "Nosocomial infection (also referred to as late onset neonatal sepsis (LOS) or health care associated infection) in the neonatal intensive care units (NICU) is associated with morbidity and mortality, prolonged hospitalization, and increased medical costs [1]. Neonates, especially premature infants, are at high risk of acquiring nosocomial infections because of impaired host-defense mechanisms, limited amounts of protective endogenous flora on skin and mucosal surfaces at the time of birth, reduced barrier function of their skin, use of invasive procedures and devices, and frequent exposure to broad-spectrum antibiotic agents [1]. "
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    ABSTRACT: Nosocomial sepsis is associated with increased mortality and morbidity including neurodevelopmental impairment and prolonged hospital stay. Prevention of sepsis especially in the preterm infants in the neonatal intensive care unit remains a major challenge. The gastrointestinal tract is an important source of potential pathogens causing nosocomial sepsis as the immature intestinal epithelium can permit translocation of bacteria and yeast. The intestinal tract and its microflora play an important role in the immunity. Altering the gut microflora has been extensively studied for immunomodulation in preterm infants. Probiotics are live microorganisms which when administered in adequate amounts confer a health benefit on the host. Probiotics have been used for prevention and treatment of various medical conditions in children and adults. Studies on probiotics in premature infants have focused on normalizing intestinal flora, improvement in feeding intolerance, prevention of necrotizing enterocolitis and sepsis. In this paper, we discuss the intestinal bacterial colonization pattern; the rational for probiotics and prebiotic therapy with special focus on the prevention of nosocomial sepsis in preterm infants.
    International Journal of Pediatrics 01/2013; 2013:874726. DOI:10.1155/2013/874726
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    Advances in Neonatal Care 02/2013; 13(1):55-74. DOI:10.1097/ANC.0b013e318278b907
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