title: Impact of relocation and environmental cleaning on reducing the incidence of healthcare-associated infection in NICU.
abstract: BACKGROUND
  Hospital environment remains a risk for healthcare-associated infections (HAIs). This was a prospective study to evaluate the comprehensive impact of relocating a neonatal intensive care unit (NICU) to a new facility and improved environmental cleaning practice on the presence of methicillin-resistant Staphylococcus aureus (MRSA) on inanimate surfaces and the incident rate of HAIs.
  
  
  METHODS
  New environmental cleaning measures were adopted after the NICU was moved to a new and better-designed location. The effect of moving and the new environmental cleaning practice was investigated by comparing the positive number of MRSA on ward surfaces and the incidence density of HAIs between the baseline and intervention periods.
  
  
  RESULTS
  Only 2.5% of environmental surfaces were positive for MRSA in the intervention period compared to 44.0% in the baseline period (P<0.001). Likewise, the total incident rate of HAIs declined from 16.8 per 1000 cot-days to 10.0 per 1000 cot-days (P<0.001).
  
  
  CONCLUSIONS
  The comprehensive measures of relocating the NICU to a new facility design with improved environmental cleaning practice are effective and significantly reduce the incidence of HAIs.
authors.affiliation: Department of NICU, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China.
authors.forename: Qiu-Fang
authors.initials: QF
authors.lastname: Li
authors.affiliation: Department of Disinfection Surveillance and Vector Control, Hangzhou Center for Disease Control and Prevention, Hangzhou, China.
authors.forename: Hong
authors.initials: H
authors.lastname: Xu
authors.affiliation: Department of Disinfection Surveillance and Vector Control, Hangzhou Center for Disease Control and Prevention, Hangzhou, China.
authors.forename: Xiao-Ping
authors.initials: XP
authors.lastname: Ni
authors.affiliation: Department of Infection Control, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China.
authors.forename: Rong
authors.initials: R
authors.lastname: Lin
authors.affiliation: Department of Disinfection Surveillance and Vector Control, Hangzhou Center for Disease Control and Prevention, Hangzhou, China.
authors.forename: Hui
authors.initials: H
authors.lastname: Jin
authors.affiliation: Department of Disinfection Surveillance and Vector Control, Hangzhou Center for Disease Control and Prevention, Hangzhou, China.
authors.forename: Ling-Ya
authors.initials: LY
authors.lastname: Wei
authors.affiliation: Department of NICU, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China.
authors.forename: Dan
authors.initials: D
authors.lastname: Liu
authors.affiliation: Department of Disinfection Surveillance and Vector Control, Hangzhou Center for Disease Control and Prevention, Hangzhou, China.
authors.forename: Lin-Hai
authors.initials: LH
authors.lastname: Shen
authors.affiliation: Department of Disinfection Surveillance and Vector Control, Hangzhou Center for Disease Control and Prevention, Hangzhou, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Zha
authors.affiliation: Department of Infection Control, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China.
authors.forename: Xin-Fen
authors.initials: XF
authors.lastname: Xu
authors.affiliation: Department of Infection Control, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China. fbygk@zju.edu.cn.
authors.forename: Bo
authors.initials: B
authors.lastname: Wu
mesh_terms: D002681:China / Q000453:epidemiology; D003428:Cross Infection / Q000453:epidemiology / Q000517:prevention & control*; D006797:Housekeeping, Hospital / Q000592:standards*; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D017053:Infection Control / Q000592:standards*; D007363:Intensive Care Units, Neonatal; D055624:Methicillin-Resistant Staphylococcus aureus; D011446:Prospective Studies; D013203:Staphylococcal Infections / Q000382:microbiology* / Q000517:prevention & control*
keywords: environmental cleaning; healthcare-associated infections; intervention; methicillin-resistant Staphylococcus aureus