Hand hygiene for the prevention of infections in neonates

• Published in: Cochrane database of systematic reviews 2021-01, Vol.1 (1), p.CD013326
• Main Authors: Kuti, Bankole Peter, Ogunlesi, Tinuade A, Oduwole, Olabisi, Oringanje, Chukwudi, Udoh, Ekong E, Meremikwu, Martin M
• Format: Article
• Language: English
• Subjects: Age Factors; Anti-Infective Agents, Local - administration & dosage; Bacterial Infections - epidemiology; Bacterial Infections - prevention & control; Bias; Child health; Chlorhexidine - administration & dosage; Chlorhexidine - analogs & derivatives; Cross-Over Studies; Hand Hygiene - methods; Hand Sanitizers - administration & dosage; Hand Sanitizers - adverse effects; Humans; Infant, Newborn; Infection; Infectious disease; Neonatal care; Neonatal Nursing - statistics & numerical data; Randomized Controlled Trials as Topic; Soaps - administration & dosage; Triclosan - administration & dosage
• ISSN: 1469-493X; 1469-493X
• DOI: 10.1002/14651858.CD013326.pub2

Annually, infections contribute to approximately 25% of the 2.8 million neonatal deaths worldwide. Over 95% of sepsis-related neonatal deaths occur in low- and middle-income countries. Hand hygiene is an inexpensive and cost-effective method of preventing infection in neonates, making it an affordable and practicable intervention in low- and middle-income settings. Therefore, hand hygiene practices may hold strong prospects for reducing the occurrence of infection and infection-related neonatal death. To determine the effectiveness of different hand hygiene agents for preventing neonatal infection in community and health facility settings. We used the standard search strategy of Cochrane Neonatal to search the Cochrane Central Register of Controlled Trials (CENTRAL; 2019, Issue 5), in the Cochrane Library; MEDLINE via PubMed (1966 to 10 May 2019); Embase (1980 to 10 May 2019); and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) (1982 to 10 May 2019). We also searched clinical trials databases and the reference lists of retrieved articles for randomised controlled trials (RCTs) and quasi-randomised trials. Searches were updated 1 June 2020. We included RCTs, cross-over trials, and quasi-RCTs that included pregnant women, mothers, other caregivers, and healthcare workers who received interventions within the community or in health facility settings DATA COLLECTION AND ANALYSIS: We used standard methodological procedures expected by Cochrane and the GRADE approach to assess the certainty of evidence. Primary outcomes were incidence of (study author-defined) suspected infection within the first 28 days of life, bacteriologically confirmed infection within the first 28 days of life, all-cause mortality within the first seven days of life (early neonatal death), and all-cause mortality from the 8th to the 28th day of life (late neonatal death). Our review included five studies: one RCT, one quasi-RCT, and three cross-over trials with a total of more than 5450 neonates (two studies included all neonates but did not report the actual number of neonates involved). Four studies involved 279 nurses working in neonatal intensive care units and all neonates on admission. The fifth study did not clearly state how many nurses were included in the study. Studies examined the effectiveness of different hand hygiene practices for the incidence of (study author-defined) suspected infection within the first 28 days of life. Two studies were rated as low