Nicu Infection Control

Evidence based guidelines for prevention of infection in NICU Dr. JP Dadhich MD,FNNF,PGD-DN

Outline ,[object Object],[object Object],[object Object]

Nosocomial Infections Relevance ,[object Object],[object Object],[object Object],[object Object],[object Object],NNPD primary cause of death EM NNPD – Time of onset of systemic infection

Risk factors for nosocomial infections ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Epidemics ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Endemic Pseudomonas aeruginosa Infection in a Neonatal Intensive Care Unit ,[object Object],[object Object],[object Object],NEJM 2000; 343 (10):695-700.

Surveillance ,[object Object],[object Object],[object Object],[object Object]

Detecting environmental reservoirs ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Cultures of the Hands of Health Care Workers ,[object Object],[object Object],[object Object],[object Object],[object Object]

Risk Factors for Colonization of the Hands with P. aeruginosa ,[object Object],[object Object],[object Object],[object Object],[object Object]

Results ,[object Object],[object Object],[object Object],[object Object],[object Object]

Infection-Control Measures ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Lessons ,[object Object],[object Object],[object Object]

E Sakazakii outbreak ,[object Object],Morbidity & Mortality Weekly Report , CDC.

Cont… ,[object Object],[object Object],[object Object],[object Object]

Cont… ,[object Object],[object Object]

Cont… ,[object Object],[object Object],[object Object]

Cont… ,[object Object],[object Object],[object Object],[object Object],[object Object]

[object Object],[object Object]

Cont… ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

[object Object],[object Object],[object Object],[object Object],[object Object]

Neonatal Serratia marcescens outbreak ,[object Object],[object Object],[object Object],[object Object],Acta Pædiatrica 97(10):2008

Flow Chart for outbreak investigation Incident Cases and Infection Rate Surveillance Cultures Processing of Specimens Pulse-field gel electrophoresis Identifying risk factors for colonization Infection control measures

Infection Control in the NICU – Recommended Standards NICU C2CE414Dd01.pdf ,[object Object],[object Object],[object Object],[object Object]

Prevention of Nosocomial Infections ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

General Housekeeping ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Recommendations for Hand Hygiene ,[object Object],[object Object],[object Object],[object Object],[object Object]

Recommended technique for Hand Hygiene ,[object Object],[object Object],[object Object],[object Object]

Recommended technique for Hand Hygiene ,[object Object]

Hand Hygiene Practices in a Neonatal Intensive Care Unit ,[object Object],[object Object],[object Object],[object Object],PEDIATRICS 2004;114 (5) :e565-e571

Use of Human-milk Feedings ,[object Object],[object Object],[object Object]

Ventilation ,[object Object],[object Object]

Catheter related blood stream infections (CDC) ,[object Object],[object Object],[object Object],CDC’s National Nosocomial Infection Surveillance System (NNIS) reported CABSIs - pooled means – 28.2/1000 catheter days in VLBW babies

RECOMMENDATIONS FOR PLACEMENT OF INTRAVASCULAR CATHETERS ,[object Object],[object Object],[object Object],[object Object],[object Object],Health-care worker education and training

Surveillance ,[object Object],[object Object]

Aseptic technique during catheter insertion and care ,[object Object],[object Object],[object Object],[object Object]

Strategies that do not Appear to Work ,[object Object],[object Object],[object Object]

Prophylactic IVIG ,[object Object],[object Object],[object Object],[object Object]

Haemopoietic Colony Stimulating Factor (G-CSF, GM-CSF) ,[object Object],[object Object],[object Object]

Gowns ,[object Object],[object Object],[object Object],[object Object]

Conclusions ,[object Object],[object Object],[object Object]

Their Future is in Our Hands  Thanks !!!! [email_address]

Antibiotics for preterm rupture of membranes (Cochrane Review - 2005) 1.98 to 10.72 4.60 Co-amoxiclav - NNEC 0.72 to 0.96 0.83 use of surfactant 0.53 to 0.87 0.68 neonatal infection 0.71 to 0.90 0.80 born within seven days of randomisation 0.58 to 0.87 0.71 born within 48 hours of randomisation 0.37 to 0.86 0.57 chorioamnionitis 95% CI RR Parameter

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