Impact of a standardized hand hygiene program on the incidence of nosocomial infection in very low birth weight infants.
BACKGROUND
This study examined the effects of a standardized hand hygiene program on the rate of nosocomial infection (NI) in very low birth weight (VLBW) infants (birth weight < 1500 g) admitted to our neonatal intensive care unit (NICU).


METHODS
We compared the rate of NI in VLBW infants in 2 separate periods. In the first period, staff were encouraged to perform handwashing using a plain fluid detergent (0.5% triclosan). In the second period, a standardized hand hygiene program was implemented using antimicrobial soap (4% chlorhexidine gluconate) and alcohol-based hand rubs.


RESULTS
NI after 72 hours of life was detected in 16 of the 85 VLBW infants in the first period and in 5 of the 80 VLBW infants in the second period. The rate of central venous catheter colonization was significantly lower in the second period (5.8%) than in the first period (16.6%).


CONCLUSIONS
In our NICU, the incidence of NI in VLBW infants was significantly reduced after the introduction of a standardized handwashing protocol. In our experience, a proper hand hygiene program can save approximately 10 NI episodes/year, at a cost of $10,000 per episode. Therefore, improving hand hygiene practice is a cost-effective program in the NICU.
Capretti
Maria Grazia
MG
Department of Preventive Pediatrics and Neonatology, St Orsola-Malpighi General Hospital, University of Bologna, Bologna, Italy. mariagrazia.capretti@virgilio.it
Sandri
Fabrizio
F
Tridapalli
Elisabetta
E
Galletti
Silvia
S
Petracci
Elisabetta
E
Faldella
Giacomo
G
D000438:Alcohols / Q000494:pharmacology; D000890:Anti-Infective Agents / Q000494:pharmacology; D002404:Catheterization; D002405:Catheterization, Central Venous; D002710:Chlorhexidine / Q000031:analogs & derivatives / Q000494:pharmacology; D003428:Cross Infection / Q000453:epidemiology* / Q000517:prevention & control*; D004864:Equipment and Supplies / Q000382:microbiology; D005260:Female; D006235:Hand Disinfection / Q000379:methods*; D006282:Health Personnel; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D017053:Infection Control / Q000379:methods*; D007363:Intensive Care Units, Neonatal; D008297:Male; D012915:Soaps / Q000737:chemistry
D000438:Alcohols; D000890:Anti-Infective Agents; D012915:Soaps; C010882:chlorhexidine gluconate; D002710:Chlorhexidine