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Hygiene routines in the EXPRESS study: impact of hygiene routines and antibiotic prophylaxis on neonatal sepsis incidence
Örebro University, School of Medical Sciences. Department of Paediatrics, Örebro University Hospital, Örebro, Sweden.ORCID iD: 0000-0002-0958-7341
Örebro University, School of Medical Sciences. Örebro University Hospital. Department of Paediatrics.
Örebro University, School of Medical Sciences.
Örebro University, Örebro University School of Business. Intervention and Implementation Research, Institute of Environmental Medicine, Karolinska Institutet, Stockholm; Department of Statistics, Örebro University, Örebro, Sweden.
(English)Manuscript (preprint) (Other academic)
National Category
General Practice
Identifiers
URN: urn:nbn:se:oru:diva-69663OAI: oai:DiVA.org:oru-69663DiVA, id: diva2:1256550
Available from: 2018-10-17 Created: 2018-10-17 Last updated: 2018-11-19Bibliographically approved
In thesis
1. Aspects of neonatal septicaemia: prevention and complications
Open this publication in new window or tab >>Aspects of neonatal septicaemia: prevention and complications
2018 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Study I was part of the Extremely Preterm Infants in Sweden Study (EXPRESS), a prospective national study including all infants born <27 weeks in Sweden in 2004-2007 that survived their first year of life (n=497). Neonatal sepsis was evaluated as a risk factor for neonatal morbidities. Definite sepsis was associated with severe bronchopulmonary dysplasia and prolonged hospital stay, but not with a higher risk of retinopathy of prematurity or intraventricular haemorrhage.

Study II was a non-randomized single-centre intervention study evaluating possible preventive effects on coagulase-negative staphylococci (CoNS) sepsis when the scrub the hub method was used. During the intervention period, the incidence of CoNS sepsis decreased from 1.5% to 0% (CI: 0.53-2.58%, p=0.06).

Study III was an in-vitro study evaluating leakage of isopropanol (IPA) and ethanol when alcohol caps and scrub the hub were used to disinfect hubs. Alcohol leakage was measured using gas chromatography. IPA was detected in all samples from cap circuits, and mean leakage increased over time. Ethanol levels were low, and scrub the hub therefore seems safe to use.

Study IV was a survey study evaluating reported hygiene routines from Swedish neonatal intensive care units (NICUs) included in the EXPRESS study. Routines were compared between the EXPRESS period (2004- 2007) and 2013. Improvements were seen regarding basic hygiene routines, routines for work clothing, and follow-up of compliance. Antibiotic prophylaxis decreased while fungal prophylaxis increased, but the empiric treatment of suspected late-onset sepsis (LOS) showed heterogeneity.

Study V investigated the association between incidence in LOS in the EXPRESS cohort and the hygiene routines previously evaluated in Study IV. Strict catheter routines, blood culture routines, and non-use of antibiotic prophylaxis were associated with decreased sepsis risk.

Place, publisher, year, edition, pages
Örebro: Örebro University, 2018. p. 90
Series
Örebro Studies in Medicine, ISSN 1652-4063 ; 186
Keywords
Neonatal sepsis, prevention, coagulase-negative staphylococci, nosocomial, hygiene, neonatal morbidity, alcohol toxicity
National Category
General Practice
Identifiers
urn:nbn:se:oru:diva-68986 (URN)978-91-7529-265-6 (ISBN)
Public defence
2018-11-16, Örebro universitet, Campus USÖ, hörsal C2, Södra Grev Rosengatan 32, Örebro, 13:00 (Swedish)
Opponent
Supervisors
Available from: 2018-09-20 Created: 2018-09-20 Last updated: 2018-10-19Bibliographically approved

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Björkman Hjalmarsson, LouiseOhlin, AndreasSchollin, JensBodin, Lennart

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CiteExportLink to record
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