title: The efficacy of clinical strategies to reduce nosocomial sepsis in extremely low birth weight infants.
abstract: The aim of this study was to evaluate the efficacy of clinical strategies to reduce nosocomial sepsis (NS) in extremely low birth weight infants (ELBWI) less than 1,000 g. Data from the period before (P1, 1995-2000) and after (P2, 2001-2002) implementation of the strategies were collected and analyzed. The intervention strategies included restriction of antibiotic therapy, less use of invasive procedures such as umbilical vessel catheterization and endotracheal intubation, establishment of guidelines for hand-washing, infant handling, and central intravascular line management. NS was defined as positive blood cultures in symptomatic patients after the third day of life with the use of antibiotics for more than 5 days. Although the gestational age (GA) and birth weight (BW) were significantly lower in P2 (GA 26.7 +/-2.1 wk; BW 796 +/-130 g) compared to P1 (GA 27.2 +/-1.6 wk; BW 857 +/-121 g), the incidence of NS decreased significantly from 70% (69/99) in P1 to 17% (24/71) in P2 with the implementation of the intervention strategies. The coagulase negative Staphylococcus infection was also significantly reduced from 34% in P1 to 11% in P2. The implementation of the clinical strategies was quite effective in reducing the incidence of NS in ELBWI.
authors.affiliation: Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 135-710, Korea.
authors.forename: Jong Hee
authors.initials: JH
authors.lastname: Hwang
authors.forename: Chang Won
authors.initials: CW
authors.lastname: Choi
authors.forename: Yun Sil
authors.initials: YS
authors.lastname: Chang
authors.forename: Yon Ho
authors.initials: YH
authors.lastname: Choe
authors.forename: Won Soon
authors.initials: WS
authors.lastname: Park
authors.forename: Son Moon
authors.initials: SM
authors.lastname: Shin
authors.forename: Munhyang
authors.initials: M
authors.lastname: Lee
authors.forename: Sang Il
authors.initials: SI
authors.lastname: Lee
mesh_terms: D003428:Cross Infection / Q000517:prevention & control*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D008297:Male; D018805:Sepsis / Q000517:prevention & control*