PREMATURITY Clinical Trial
Official title:
Does Skin-to-skin Contact Promote Bacterial Decolonization in Preterm Infants in Neonatal Intensive Care Unit? A Randomized, Single-blinded Controlled Trial
BACKGROUND Decolonization with topical antibiotics is necessary to prevent and / or control
outbreaks of multidrug-resistant bacterial infection in the NICU (Neonatal Intensive Care
Unit), but can trigger bacterial resistance. The objective of this study was to determine
whether skin-to-skin contact of newborns colonized with MRSA (Methicillin-Oxacillin
Resistant Staphylococcus Aureus) with their mothers could be an effective alternative for
biological control of bacterial colonization.
METHODS: The investigators studied 102 newborns admitted to NICU in three public hospitals
in São Luís, Brazil. Inclusion criteria were birth weight from 1300 to 1800g, length of stay
>4 days, newborns colonized by Staphylococcus aureus and/or Staphylococcus
coagulase-negative methicillin-oxacillin resistant and mothers not colonized by these
bacteria. Randomization was performed using a computer generated random numbers algorithm.
Allocation to intervention and control groups was performed for each eligible newborn using
a sealed opaque envelope. In the intervention group (n = 53) mother-infant skin-to-skin
contact was held twice a day. The control group (n = 49) received routine care without
skin-to-skin contact. There was no masking of newborn's mothers or researchers, but the
individuals who carried out bacterial cultures and assessed results were kept blind to group
allocation.
The primary outcome was decolonization of newborns' nostrils after 7 days of intervention.
Safety was assessed by monitoring vital signs of newborns during the intervention. The
secondary outcome was emergence of late onset presumed sepsis until the end of
hospitalization period or 28 days of life, whatever happened first.
FUNDING: CNPq (Brazilian Research Council) and FAPEMA (Maranhão Research Foundation)
n/a
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind (Outcomes Assessor), Primary Purpose: Prevention
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