title: [Five steps to decreasing nosocomial infections in large immature premature infants: A quasi-experimental study].
abstract: OBJECTIVE
  An evaluation is made of the impact of a series of five interventions on the incidence of hospital-related infections in a level iii neonatal unit.
  
  
  METHODS
  Quasi-experimental, pre-post intervention study, which included preterm infants weighing 1,500g at birth or delivered at <32 weeks gestation, admitted in the 12 months before and after the measures were implemented (January 2014). The measures consisted of: optimising hand washing, following a protocol for insertion and handling of central intravenous catheters, encouraging breastfeeding; applying a protocol for rational antibiotic use, and establishing a surveillance system for multi-resistant bacteria. The primary endpoint was to assess the incidence of hospital-acquired infections before and after implementing the interventions.
  
  
  RESULTS
  Thirty-three matched patients were included in each period. There was an incidence of 8.7 and 2.7 hospital-related infections/1,000 hospital stay days in the pre- and post-intervention periods, respectively (P<.05). Additionally, patients in the treatment group showed a statistically-significant decrease in days on mechanical ventilation, use of blood products, and vasoactive drugs.
  
  
  CONCLUSIONS
  The strategy, based on implementing five specific measures in a unit with a high rate of hospital-related infections, proved effective in reducing their incidence. This reduction could contribute to lowering the use of mechanical ventilation, blood products, and vasoactive drugs.
authors.affiliation: Sección de Neonatología, Servicio de Pediatría, Hospital General Universitario Santa Lucía, Cartagena, Murcia, España. Electronic address: galapagos772000@yahoo.es.
authors.forename: Ana
authors.initials: A
authors.lastname: García González
authors.affiliation: Sección de Neonatología, Hospital General Universitario Santa Lucía, Cartagena, Murcia.
authors.forename: José Luis
authors.initials: JL
authors.lastname: Leante Castellanos
authors.affiliation: Sección de Neonatología, Servicio de Pediatría, Hospital General Universitario Santa Lucía, Cartagena, Murcia, España.
authors.forename: Carmen
authors.initials: C
authors.lastname: Fuentes Gutiérrez
authors.affiliation: Sección de Neonatología, Servicio de Pediatría, Hospital General Universitario Santa Lucía, Cartagena, Murcia, España.
authors.forename: José María
authors.initials: JM
authors.lastname: Lloreda García
authors.affiliation: Sección de Neonatología, Servicio de Pediatría, Hospital General Universitario Santa Lucía, Cartagena, Murcia, España.
authors.forename: José Ramón
authors.initials: JR
authors.lastname: Fernández Fructuoso
authors.affiliation: Sección de Neonatología, Servicio de Pediatría, Hospital General Universitario Santa Lucía, Cartagena, Murcia, España.
authors.forename: Elisabet
authors.initials: E
authors.lastname: Gómez Santos
authors.affiliation: Sección de Neonatología, Servicio de Pediatría, Hospital General Universitario Santa Lucía, Cartagena, Murcia, España.
authors.forename: Verónica
authors.initials: V
authors.lastname: García González
mesh_terms: D001724:Birth Weight; D003428:Cross Infection / Q000453:epidemiology / Q000517:prevention & control*; D005260:Female; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000453:epidemiology / Q000382:microbiology* / Q000517:prevention & control*; D017053:Infection Control / Q000379:methods*; D008297:Male
keywords: Breastfeeding; Catheter-associated infections; Estrategias para disminuir las infecciones; Infecciones asociadas a catéter; Infección relacionada con la asistencia sanitaria; Lactancia materna; Neonato prematuro; Nosocomial infection; Preterm neonate; Strategies to reduce infections