Gloves after hand washing associated with fewer infections in preterm babies

August 11, 2014, The JAMA Network Journals

Extremely premature babies in a neonatal intensive care unit (NICU) had fewer infections when medical staff wore gloves after washing their hands compared with hand washing alone.

The author is David A. Kaufman, M.D., of the University of Virginia School of Medicine, Charlottesville, and colleagues.

Late-onset infections (more than 72 hours after birth) and necrotizing enterocolitis (NEC, tissue death in the intestines) can cause death and neurodevelopmental impairment in extremely . Even after hand washing, can still have microorganisms on their hands. This can be dangerous for extremely preterm newborns because of their immature immune systems and underdeveloped skin and mucosal barriers.

The authors examined whether wearing nonsterile gloves after hand washing and before all direct patient, bed and/or catheter contact, compared with hand washing alone, would prevent late-onset infections or NEC in preterm babies who weighed less than 1,000 grams and/or had a gestational age of less than 29 weeks and were less than 8 days old. The randomized clinical trial at a single hospital NICU included 120 infants who were enrolled during a 30-month study period from December 2008 to June 2011. Infants were divided in two groups: 60 infants in group A where nonsterile gloves were used after hand washing and 60 infants in group B where alone was used.

Late-onset invasive or NEC occurred in 32 percent of infants (19 of 60) in group A compared with 45 percent of infants (27 of 60) in group B. In group A compared with group B, there also were 53 percent fewer gram-positive and 64 percent fewer central line-associated bloodstream infections.

"This readily implementable control measure to reduce infections in while they have central or peripheral venous access warrants further study in this and other patient populations."

In a related editorial, Susan E. Coffin, M.D., M.P.H., of the University of Pennsylvania, Philadelphia, writes: "In this issue, Kaufman and colleagues describe their efforts to reduce the risk of infection among critically ill neonates. Late-onset infections are devastating for infants."

"While planning their study, the investigators used current data from their institution on the incidence of late-onset infection among extremely low-birth-weight 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," Coffin notes.

"It is important to recognize that universal glove use might lead to several unintended consequences. Glove use has been found by many investigators to be one of the key barriers to appropriate hand hygiene," Coffin continues.

"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," Coffin concludes.

Explore further: Risk factor for life-threatening disease in preemies identified

More information: JAMA Pediatr. Published online August 11, 2014. DOI: 10.1001/jamapediatrics.2014.953.

JAMA Pediatr. Published online August 11, 2014. DOI: 10.1001/jamapediatrics.2014.1269

Related Stories

Risk factor for life-threatening disease in preemies identified

January 16, 2014
Many premature infants suffer a life-threatening bowel infection called necrotizing enterocolitis (NEC).

Gut bacteria can cause life-threatening infections in preterm babies

March 19, 2014
Babies born prematurely are surviving in increasing numbers. But many withstand complications of early birth only to suffer late-onset sepsis—life-threatening bloodstream infections that strike after infants reach 72 hours ...

'Superbug' MRSA infections aren't dropping in children: CDC

September 23, 2013
(HealthDay)—Although rates of infection with methicillin-resistant staphylococcus aureus (MRSA) are declining among American adults, the rates among children remain largely unchanged, a new government study finds.

Medication does not lower risk of fungal infection, death among ELBW infants

May 3, 2014
Use of the antifungal medication fluconazole for six weeks for extremely low birth-weight infants did not significantly reduce the risk of death or invasive candidiasis, a serious infection that occurs when candida (a type ...

Maternal singing during skin-to-skin contact benefits both preterm infants and their mothers

August 4, 2014
A mother who sings to her preterm infant while providing 'kangaroo care,' or holding with direct skin-to-skin contact, may see improvements in both her child's and her own health. The finding comes from an Acta Paediatrica ...

Urine test identifies babies at most risk of necrotizing enterocolitis

April 15, 2013
Abnormal gut bacteria in premature babies can be found days before the onset of necrotizing enterocolitis (NEC) finds new research in BioMed Central's open access journal Microbiome. Babies who later went on to develop NEC ...

Recommended for you

Phone-addicted teens are unhappy, study finds

January 22, 2018
Happiness is not a warm phone, according to a new study exploring the link between adolescent life satisfaction and screen time. Teens whose eyes are habitually glued to their smartphones are markedly unhappier, said study ...

Baby brains help infants figure it out before they try it out

January 17, 2018
Babies often amaze their parents when they seemingly learn new skills overnight—how to walk, for example. But their brains were probably prepping for those tasks long before their first steps occurred, according to researchers.

NeuroNext biomarker study explores natural history of infantile-onset SMA

January 9, 2018
Research led by The Ohio State University Wexner Medical Center to define the natural history of infantile-onset spinal muscular atrophy (SMA) has been "critical" to accelerate the development of effective therapies and hasten ...

No link between childhood lead levels, later criminality

December 27, 2017
(HealthDay)— Exposure to higher levels of lead during early childhood can affect neurological development—but does that mean affected kids are doomed to delinquency?

Early puberty in girls may take mental health toll

December 26, 2017
(HealthDay)—A girl who gets her first menstrual period early in life—possibly as young as 7—has a greater risk for developing depression and antisocial behaviors that last at least into her 20s, a new study suggests.

Technology not taking over children's lives despite screen-time increase

December 21, 2017
With children spending increasing amounts of time on screen-based devices, there is a common perception that technology is taking over their lives, to the detriment and exclusion of other activities. However, new Oxford University ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.