Article

Preventing nosocomial bloodstream infection in very low birth weight infants

Department of Pediatrics, Children's Hospital at Dartmouth, One Medical Center Drive, Lebanon, New Hampshire 03756, USA.
Seminars in Neonatology 09/2002; 7(4):325-33. DOI: 10.1053/siny.2002.9125
Source: PubMed

ABSTRACT

Nosocomial sepsis is a frequent complication of caring for very low birth weight infants and incidence varies substantially among centres. Many cases are preventable. An organized approach to understanding the epidemiology of nosocomial sepsis within a unit, and implementing evidence-based practices can successfully reduce the incidence. Diagnostic accuracy is important to limit excess empiric antibiotic therapy. Instituting a hand hygiene program of education, monitoring, and consideration of waterless hand disinfectants to avoid hand transmission of organisms is essential. An emphasis on early achievement of enteral nutrition, preferably with human milk is important to reduce unnecessary exposure to central catheters and parenteral nutrition. Use of maximum sterile barrier precautions by personnel trained and skilled in central catheter insertion, followed by meticulous care in preventing catheter hub contamination will reduce the incidence of catheter related sepsis. Ultimately, the culture of the NICU needs to shift from a focus on early detection of infection to one of prevention.

Full-text preview

Available from: qiteamspace.org
  • [Show abstract] [Hide abstract]
    ABSTRACT: Las infecciones asociadas a catéter son la primera causa de infección nosocomial descrita en las unidades de cuidado crítico y un control de estas conlleva a disminuir la morbilidad y mortalidad en estos pacientes, tiempos de estancia hospitalaria y aliviar el costo de una hospitalización prolongada para su familia y la sociedad. Objetivo : evaluar la evidencia en las estrategias de prevención de las infecciones asociadas a catéter en recién nacidos. Materiales y métodos : se realizó una búsqueda sistemática en: Cochrane, Pubmed, desde 1995 hasta Abril de 2009. Se seleccionaron revisiones sistmáticas, ensayos clínicos y estudios observacionales. Se utilizó le metodología SIGN para la calificación de los estudios y evaluar el grado de recomendación basada en la evidencia. Resultados : se evaluaron 13 estudios que cumplían con los criterios de inclusión y que respondían a 6 preguntas sobre las diferentes estrategias para la prevención de infecciones asociadas a catéter en recién nacidos. La heterogenicidad de las investigaciones no permitió la realización de metananálisis. Conclusiones : la implementación de un sistema de control y vigilancia en el seguimiento de todos los procesos con mayor atención en todas las medidas de colocación, cuidado y manejo de los catéteres centrales son de forma integral la mejor estrategia en la prevención de infecciones asociadas a catéter en recién nacidos. Vascular catheters are consider fundamental in Neonatal Intensive Care Units and it's insertion is the most common procedure. 1 Blood related catheter infections (BRCI) are the first nosocomial infection related diseases all purposes to diminished them reduces mobility and mortality, hospitalization and relieves costs for long hospital stays for families and society. 2 There has been many control measures but there are not consensus based on evidence to give general recommendations on this age group. Objective Evaluate evidence on prevention measures for BRCI in newborns. Materials and Methods A systematic search was made at: Cochrane, Pubmed, from 1995 to April 2009. Systematic reviews, randomized controlled trials, case control and cohort studies were analyzed by SIGN evidence methodology. Results Thirteen studies met inclusion criteria and answered to 6 questions about different prevention strategies for blood catheter related infections in newborns. Studies heterogeneity didn't allow to make methanalysis. Conclusions Implementation of a surveillance protocol in all process with handling catheters seems to be the best strategy on preventing BRCI in newborns.
    No preview · Article ·
  • Source

    Full-text · Article ·
  • Source

    Preview · Article ·
Show more