title: Practices related to late-onset sepsis in very low-birth weight preterm infants.
abstract: OBJECTIVE
  To understand the practices related to late-onset sepsis (LOS) in the centers of the Brazilian Neonatal Research Network, and to propose strategies to reduce the incidence of LOS.
  
  
  METHODS
  This was a cross-sectional descriptive multicenter study approved by the Ethics Committee. Three questionnaires regarding hand hygiene, vascular catheters, and diagnosis/treatment of LOS were sent to the coordinator of each center. The center with the lowest incidence of LOS was compared with the others.
  
  
  RESULTS
  All 16 centers answered the questionnaires. Regarding hand hygiene, 87% use chlorhexidine or 70% alcohol; alcohol gel is used in 100%; 80% use bedside dispensers (50% had one dispenser for every two beds); practical training occurs in 100% and theoretical training in 70% of the centers, and 37% train once a year. Catheters: 94% have a protocol, and 75% have a line insertion team. Diagnosis/treatment: complete blood count and blood culture are used in 100%, PCR in 87%, hematological scores in 75%; oxacillin and aminoglycosides is the empirical therapy in 50% of centers. Characteristics of the center with lowest incidence of LOS: stricter hand hygiene; catheter insertion and maintenance groups; use of blood culture, PCR, and hematological score for diagnosis; empirical therapy with oxacillin and aminoglycoside.
  
  
  CONCLUSIONS
  The knowledge of the practices of each center allowed for the identification of aspects to be improved as a strategy to reduce LOS, including: alcohol gel use, hand hygiene training, implementation of catheter teams, and wise use of antibiotic therapy.
authors.affiliation: Hospital das Clínicas, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista (UNESP), Botucatu, SP, Brazil. Electronic address: mbentlin@fmb.unesp.br.
authors.forename: Maria Regina
authors.initials: MR
authors.lastname: Bentlin
authors.affiliation: Hospital das Clínicas, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista (UNESP), Botucatu, SP, Brazil.
authors.forename: Ligia M S S
authors.initials: LM
authors.lastname: Rugolo
authors.affiliation: Hospital Universitário de Londrina, Universidade Estadual de Londrina (UEL), Londrina, PR, Brazil.
authors.forename: Ligia S L
authors.initials: LS
authors.lastname: Ferrari
mesh_terms: D000328:Adult; D001938:Brazil / Q000453:epidemiology; D002710:Chlorhexidine; D003430:Cross-Sectional Studies; D004202:Disinfectants; D000431:Ethanol; D005782:Gels / Q000627:therapeutic use; D019983:Guideline Adherence; D006235:Hand Disinfection / Q000379:methods*; D063373:Hand Hygiene / Q000379:methods*; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D007234:Infant, Premature; D019102:Infant, Very Low Birth Weight; D018805:Sepsis / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control*; D011795:Surveys and Questionnaires; D062666:Vascular Access Devices / Q000592:standards
chemical_list: D004202:Disinfectants; D005782:Gels; D000431:Ethanol; D002710:Chlorhexidine
keywords: Hand hygiene; Higiene das mãos; Newborn; Premature; Prematuro; Prevention and control; Prevenção & controle; Recém-nascido; Sepse; Sepsis