The efficacy of clinical strategies to reduce nosocomial sepsis in extremely low birth weight infants.
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.
Hwang
Jong Hee
JH
Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 135-710, Korea.
Choi
Chang Won
CW
Chang
Yun Sil
YS
Choe
Yon Ho
YH
Park
Won Soon
WS
Shin
Son Moon
SM
Lee
Munhyang
M
Lee
Sang Il
SI
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*