title: Does the number of exogenous infections increase in paediatric oncology patients when sterile surgical gloves are not worn for accessing central venous access devices?
abstract: The aim of this study was to determine whether the routine use of sterile gloves when accessing central venous catheters (CVCs) affects the incidence of exogenous septicaemia in paediatric oncology patients. The 36-month study period ran prospectively from September 2000 to August 2003. During this time the routine use of sterile gloves for accessing CVCs was suspended. Sterile gloves were only used when obtaining blood samples from the line or injecting substances that required direct entry into the lumen with removal of line cap. Surveillance cultures of throat and rectum were obtained to detect carriage of potential pathogens. Exogenous septicaemia was defined as a blood stream infection due to microorganisms not carried by the patient in throat and/or rectum. The incidence of exogenous septicaemia following a change of practice of not routinely using sterile gloves for accessing lines was compared to the incidence of exogenous septicaemia in a historical control group. The number of exogenous septicaemia episodes per inpatient days with gloves and without gloves was calculated for the total number of episodes and for the first episode for each child. The relative incidence and 95% confidence intervals was also calculated for first and total episodes. For both, all episodes and first episodes there was no statistically significant difference in the incidence of exogenous septicaemia comparing the control and study patients. In summary, this study does not support or approve the use of sterile gloves when accessing CVCs in respect of exogenous septicaemia.
authors.affiliation: Oncology Unit, Royal Liverpool Children's NHS Trust, Alder Hey, Eaton Road, Liverpool L12 2AP, UK. Sue.Hemsworth@rlc.nhs.uk
authors.forename: Sue
authors.initials: S
authors.lastname: Hemsworth
authors.forename: Karen
authors.initials: K
authors.lastname: Selwood
authors.forename: Rick
authors.initials: R
authors.lastname: van Saene
authors.forename: Barry
authors.initials: B
authors.lastname: Pizer
mesh_terms: D000293:Adolescent; D001431:Bacteriological Techniques; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D015400:Clinical Nursing Research; D016001:Confidence Intervals; D003428:Cross Infection / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D004739:England / Q000453:epidemiology; D005260:Female; D005932:Gloves, Surgical / Q000706:statistics & numerical data*; D006757:Hospital Units / Q000458:organization & administration; D006776:Hospitals, Pediatric; D006801:Humans; D015994:Incidence; D007223:Infant; D017053:Infection Control / Q000379:methods*; D008297:Male; D009369:Neoplasms / Q000150:complications* / Q000628:therapy; D009730:Nursing Assessment / Q000458:organization & administration; D009859:Oncology Nursing / Q000458:organization & administration; D010371:Pediatric Nursing / Q000458:organization & administration; D011446:Prospective Studies; D018805:Sepsis / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control