Neonatal Infection Clinical Trial
Official title:
Gloving and Handwashing to Prevent Invasive Infections in Necrotizing Enterocolitis
The purpose of this study is to compare the additional use of gloves (with handwashing before and after gloving) for all patient contact while infants have intravenous (central or peripheral) access in a RCT. Preterm infants <1000 grams or less than 29 weeks gestational age will be randomized after birth to either a handwashing-gloving group or handwashing only group. The primary outcome will be the incidence of invasive infections (bacterial or fungal) or necrotizing enterocolitis. Secondary outcomes will include hospital days, preterm morbidities, mortality, and hospital costs.
All infants who had a birth weight of less than or equal to 1000 grams or who were born less
than 29 weeks gestation were eligible for this study. 120 subjects were randomized by day of
life(dol) 8 to one of two study groups--hand hygiene or hand hygiene plus gloving. Study
signs were placed at the bedside and on the isolette sides of each infant with the
appropriate study group guidelines.
The investigators goal was to target the time period these infants are at high-risk for
infection or NEC and its associated mortality. The targeted time was the first 4 weeks of
life or longer while intravenous access is still required. The average age for the first
episode of late-onset sepsis is 22(+/-0.5) days (median: 17 days; 75th percentile: 28 days;
95th percentile: 57 days). The majority of infections that occur after 4 weeks of life are
in patients still requiring IV access (peripheral or central). The presence of an
intravenous line in this group of preterm infants correlates with the presence of risk
factors for infection that would necessitate the need for intravenous access including:
parenteral nutrition, lipid infusion, use of broad spectrum antibiotics, and the intravenous
line itself (if it is a central venous catheter). This strategy focused on the individual
infant's risks, limits exposure to and decreases cost of intervention.
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Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Prevention
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