Using Gloves Post Hand-Washing Linked to Fewer Infections in Premature Infants
Infants who are born prematurely have to stay in the neonatal intensive care unit (NICU) where they receive treatment. Even though preterm babies are placed under intensive care, they are still at risk of developing infections. In a new study, researchers set out to examine the effects of using gloves and found that when the medical staff used gloves after hand washing, the infants' risk of infections fell.
For this study, the team headed by David A. Kaufman, M.D., of the University of Virginia School of Medicine, Charlottesville focused on late-onset infections that occur more than 72 hours post-birth and necrotizing enterocolitis (NEC), which is when the tissue dies in the intestines. Both conditions can lead to death and/or neurodevelopmental impairment. They recruited two groups of infants. In group A, there were 60 premature infants who were handled by medical staff that washed their hands and used sterile gloves. In group B, the 60 infants were handled by people who only washed their hands.
Overall, 32 percent or 19 infants suffered from late-onset invasive infection or NEC in group A. In group B, however, the rate was higher at 45 percent or 27 infants. The researchers added that infants in group A had 53 percent fewer cases of gram-positive bloodstream infections. They also had 64 percent fewer cases of central line-association bloodstream infections.
"This readily implementable control measure to reduce infections in preterm infants while they have central or peripheral venous access warrants further study in this and other patient populations," the authors concluded according to the press release.
Despite the study's findings, one expert questioned the study's data in a related editorial.
Susan E. Coffin, M.D., M.P.H., of the University of Pennsylvania, Philadelphia, wrote: "While planning their study, the investigators used current data from their institution on the incidence of late-onset infection among extremely low-birth-weight infants to calculate a sample size that would allow them to detect a clinically relevant difference in outcome. Unfortunately for the investigators - but fortunately for their patients - the background rate of late-onset infections appears to have dropped significantly from the time they performed their sample size calculations to the study period (from 60 percent to 45 percent), thus rendering their study underpowered."
She added, "At this point, we should applaud Kaufman and colleagues for tackling a challenging and important problem, lobby funding institutions to support additional well-designed infection prevention trials, and await additional data before donning these gloves."
The study was published in JAMA Pediatrics.