J Korean Med Sci.  2005 Apr;20(2):177-181. 10.3346/jkms.2005.20.2.177.

The Efficacy of Clinical Strategies to Reduce Nosocomial Sepsis in Extremely Low Birth Weight Infants

Affiliations
  • 1Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. mhlee@smc.samsung.co.kr
  • 2Samsung Cheil Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.

Abstract

The aim of this study was to evaluate the efficacy of clinical strategies to reduce nosocomial sepsis (NS) in extremely low birth weight infants (ELBWI) less than 1,000 g. Data from the period before (P1, 1995-2000) and after (P2, 2001-2002) implementation of the strategies were collected and analyzed. The intervention strategies included restriction of antibiotic therapy, less use of invasive procedures such as umbilical vessel catheterization and endotracheal intubation, establishment of guidelines for hand-washing, infant handling, and central intravascular line management. NS was defined as positive blood cultures in symptomatic patients after the third day of life with the use of antibiotics for more than 5 days. Although the gestational age (GA) and birth weight (BW) were significantly lower in P2 (GA 26.7 +/-2.1 wk; BW 796 +/-130 g) compared to P1 (GA 27.2 +/-1.6 wk; BW 857 +/-121 g), the incidence of NS decreased significantly from 70% (69/99) in P1 to 17% (24/71) in P2 with the implementation of the intervention strategies. The coagulase negative Staphylococcus infection was also significantly reduced from 34% in P1 to 11% in P2. The implementation of the clinical strategies was quite effective in reducing the incidence of NS in ELBWI.

Keyword

Nosocomial Infection; Cross Infection; Infants, Very Low Birth Weight; Invasive Procedures; Intu-bation; Catheterization; Staphylococcus

MeSH Terms

Cross Infection/*prevention & control
Female
Humans
Infant, Newborn
*Infant, Very Low Birth Weight
Male
Sepsis/*prevention & control

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