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Eficacia de la limpieza corporal con clorhexidina en prevenir la sepsis neonatal en cuidado intensivo revisión sistemática
- Source :
- Lawn J, Cousens S, Bhutta Z, al e. Why are 4 million newborn babies dying each year? Lancet. 2004; 364: p. 399–401., Black R, Cousens S, Johnson H, al e..; Child Health Epidemiology Reference Group of WHO and UNICEF. Global, regional, and national causes of child mortality in 2008: a systematic analysis. Lancet. 2010; 375: p. 1969–1987., Haines A, Cassels A. Can the millennium development goals be attained? BMJ. 2004; 329: p. 394–397, Auriti C. Risk factors for nosocomial infections in a neonatal intensive-care unit. Journal of Hospital infections. 2003; 53(1): p. 25-30., Borghesi A, Stronati M. Strategies for the prevention of hospital-acquired infections in the neonatal intensive care unit. Journal of Hospital infections. 2008; 68: p. 293-300., Corrales I, Álvarez M, Cortes J. Impacto de una intervención de precauciones de contacto sobre la infección intrahospitalaria en una unidad neonatal. Bogotá: Fundación Cardioinfantil-Universidad del Rosario, Unidad De Cuidados Intensivos Neonatales ; 2010., Andersen C, Hart J, Vemgal P, al e. Prospective evaluation of a multi-factorial prevention strategy on the impact of nosocomial infection in very-lowbirthweightinfants. Journal of Hospital Infections. 2005; 61: p. 162–7., Polin R, Denson S, Brady M. Strategies for prevention of health careassociated infections in the NICU. Pediatrics. 2012; 129: p. e1085–93, Sherman M. New concepts of microbial translocation in the neonatal intestine: mechanisms and prevention. Clinical Perinatology. 2010; 37(3): p. 565-79., Rotimi V, Olowe S, Ahmed I. The development of bacterial flora of premature neonates. J Hyg (Lond). 1985; 94(3): p. 309-18., Madan J, Farzan S, Hibberd P, Karagas M. Normal neonatal microbiome variation in relation to environmental factors, infection and allergy. Curr Opin Pediatr. 2012; 24(6): p. 753-9., Yatsunenko T, Rey F, Manary M, Trehan I, Dominguez-Bello M, Contreras M, et al. Human gut microbiome viewed across age and geography. Nature. 2012; 486: p. 222-7., Fernandez P, Dolinger E, Abdallah V, Resende D, Gontijo Filho P, Brito D. Late onset sepsis and intestinal bacterial colonization in very low birth weight infants receiving long-term parenteral nutrition. Rev Soc Bras Med Trop. 2011; 44(4): p. 447-50., Carl M, Ndao I, Springman A, Manning S, Johnson J, Johnston B, et al. Sepsis from the gut: the enteric habitat of bacteria that cause late-onset neonatal bloodstream infections. Clin Infect Dis. 2014; 58(9): p. 1211-8., Capone K, Dowd S, Stamatas G, Nikolovski J. Diversity of the human skin microbiome early in life. J Invest Dermatol. 2011; 131(10): p. 2026-32., Visscher M, Chatterjee R, Munson K, Pickens W, Hoath S. Changes in diapered and nondiapered infant skin over the first month of life. Pediatr Dermatol. 2000; 17(1): p. 45-51., Harpin V, Rutter N. Barrier properties of the newborn infant's skin. J Pediatr. 1983; 102(3): p. 419-25., Powers R, Wirtschafter D. Decreasing Central Line Associated Bloodstream Infection in Neonatal Intensive Care. Clinical Perinatology. 2010; 37: p. 247–27., Sankar J, Vinod P. Efficacy and Safety of Whole Body Skin Cleansing With Chlorhexidine in Neonates—A Systemic Review. Pediatric Infectious Journal. 2013; 32(6)., Pereira L, Chipato T, Mashu A, al e. Randomized study of vaginal and neonatal cleansing with 1% chlorhexidine. International Journal of Gynecology and obstetrics. 2011; 112: p. 234–238., Milstone A, Elward A, X S. Daily chlorhexidine bathing to reduce bacteremia in critically ill children: a multicentre, cluster-randomised, crossover trial. Lancet. 2013; 381., Sola A. Cuidados neonatales. Edimed. 2011; 519-535., JD S. Healthcare Infection Control Practices Advisory Committee. [Online].; 2007 [cited 2015 enero 2. Available from: www.cdc.gov/ncidod/dhqp/pdf/guidelines/ Isolation1007.pdf., Wynn J. Pathophysiology and Treatment of Septic Shock in Neonates. Clinical perinatology. 2010; 37: p. 439–479., Stronati M, Bollani L. Neonatal sepsis: new preventive strategies. Minerva Pediatrica. 2013; 65(1): p. 103-10., Borghesi A, Tzialla C. New possibilities of prevention of infection in the newborn. Journal of maternal-fetal and neonatal medicine. 2011; 24(Supple 2): p. 28-30., Saiman L. Strategies for prevention of nosocomial sepsis in the neonatal intensive care unit. Current Opinion of Pediatrics. 2006; 18(2): p. 101-6., Montes M, Ares S, Sola A. Recomendaciones de la Sociedad Iberoamericana de Neonatología (SIBEN). Consenso Utilización de soluciones antisépticas en recién nacidos. Bogotá:; 2008., Saleem S, Rouse D, McClure E, al e. Chlorhexidine vaginal and infant wipes to reduce perinatal mortality and morbidity: a randomized controlled trial. Obstet Gynecol. 2010; 115: p. 1225–1232., MJ S, Paul V, Kapil A, al. e. Does skin cleansing with chlorhexidine affect skin condition, temperature and colonization in hospitalized preterm low birth weight infants?: a randomized clinical trial. Journal of Perinatology. 2009; 29: p. 795–801., Enríquez DÁM, Barrero M. Guía de prevención, vigilancia epidemiológica y control de las infecciones asociadas al cuidado de la salud en las unidades de recién nacidos. Bogotá: Secretaria de salud; 2011., Coronel W. Sepsis Neonatal. Revista de enfermedades infecciosas en pediatría. 2009; 23., Vergnano S, Sharlad M. Neonatal Sepsis: an International Perspective. Arch Dis Child Fetal and Neonatal. 2005; 90: p. 220-224., Lawn J, Cousens S, Zupan J. 4 million neonatal deaths: when? Where? Why? Lancet. 2005; 365(9462): p. 891–900., Ayman A. Is Bloodstream Infection Preventable Among Premature Infants? A tale of two. Pediatrics. 2005; 115: p. 1513., Piantino J. Culture Negative Sepsis and Systemic Inflammatory Response Syndrome in neonates. Neonatal Reviews. 2013; 14: p. e294, Reyna-Figueroa J. Disparity in the criteria for including patients with neonatal sepsis in scientific medical studies. Are we swimming in a sea without limits? Anales de pediatria. 2006; 65(6): p. 536–540., Kilbride H, Wirtschafter D, Powers R, al. e. Implementation of evidence based potentially better practices to decrease nosocomial infections. Pediatrics. 2003; 111: p. e519–33., Bloom B, Craddock A, Delmore P, al e. Reducing acquired infections in the NICU: observing and implementing meaningful differences in processbetween high and low acquired infection rate centers. Journal of perinatology. 2003; 23: p. 489–92, Saiman L. Strategies for prevention of nosocomial sepsis in the neonatal intensive care unit. Current opinion in pediatrics. 2006; 18(2): p. 101-6., Shah P, Shah V. Continuous heparin infusion to prevent thrombosis and catheterocclusion in neonates with peripherally placed percutaneous central venous catheters. Cochrane database of systematic reviews. 2005., Rosemberg A, SD A, Delaware W, Peterseon A. Safety and efficacy of the antiseptic chlorhexidine gluconate. Sugery, Gynecology-obstetrics. 1976; 143., Chaiyakunapruk N, Veenstra D, Lipsky B, Saint S. Clorhexidine compared with povidone-iodine.solution for vascular catheter-site care: A meta-analysis. Annals of internal medicine. 2002; 136(11): p. 792-801., Bakr A, Karkour T. Effect of predelivery vaginal antisepsis on maternal and neonatal morbidity and mortality in Egypt. J Womens Health (Larchmt). 2005; 14: p. 496–50., Taha T, Biggar R, Broadhead R, al e.. Effect of cleansing the birth canal with antiseptic solution on maternal and newborn morbidity and mortality in Malawi: clinical trial. BMJ. 1997; 315: p. 216–219., Tamma P. Chlorhexidine use in the Neonatal Intensive Care Unit: Results from a National Survey. Infect Control Hosp Epidemiol. 2010; 31(8): p. 846–849., Mullany LC, Kahtry SK, Sherchand JB, LeClerq SC, Darmastadt GL, Katz J, Gauchan P, et al. Arandomizedcontrolled trial of theimpact of chlorhexidineskincleansingonbacterialcolonization of hospital-borninfants in Nepal. PediatricInfectDis J 2008; 27 (6): 505-511., Tielsch J, Darmstadt GL, Mullany LC, Khatry SK, Katz J, LeClerq SC, Shrestha S, et al. Impact of newbornskin-cleansingwithchlorexidineon neonatal mortlity in southern Nepal: a community-basedcluster-randomized trial. Pediatrics 2007; 119 (2): e330-e340., Darmstadt GL, Hossain M, Choi Y, Shirin M, Mullany LC, Islam M, Saha S. Safety and effect of chlorhexidineskincleansingonskin flora of neonates in Bangladesh. PediatricInfectDis J 2007; 26 (6): 492-495., Sankar MJ, Paul VK, Kapil A, Kalaivani M, Agarwal R, Darmstadt GI, Deorari AK. Doesskincleansingwithchlorexidineaffectskincondition, temperature and colonization in hospitalizedpretermlowbirthweightinfants?: A randomizedclinical trial. J Perinatol 2009; 29: 795-801., Gupta B, Das Vaswani N, Sharma D, Chaudhary U, Lekhwani S. Evaluation of efficacy of skincleansingwithclorhexidine in prevention of neonatal nosocomial sepsis-a randomizedcontrolled trial. J Matern Fetal Neonatal Med. En prensa., Chapman AK, Aucott SW, Milstone AM. Safety of chlorhexidine gluconate used for skin antisepsis in the preterm infant. J Perinatol 2012; 32 (1): 4-9., Imdad A, Bautista RM, Senen KA, Uy ME, Mantaring JB 3rd, Bhutta ZA. Umbilical cord antiseptics for preventing sepsis and death among newborns. Cochrane Database Syst Rev. 2013 May 31;5:CD008635, Sankar MJ, Paul VK. Efficacy and safety of whole body skin cleansing with chlorhexidine in neonates--a systemic review. Pediatr Infect Dis J 2013; 32( 6): e227-34., Garland JS, Alex CP, Mueller CD, et al. A randomized trial comparing povidone-iodine to a chlorhexidine gluconate-impregnated dressing for prevention of central venous catheter infections in neonates. Pediatrics 2001; 107:1431–6., Repositorio EdocUR-U. Rosario, Universidad del Rosario, instacron:Universidad del Rosario
- Publication Year :
- 2015
- Publisher :
- Universidad del Rosario, 2015.
-
Abstract
- ANTECEDENTES. La mortalidad neonatal se debe principalmente a procesos infecciosos y a prematurez. Se ha sugerido que el lavado corporal total con clorhexidina podría reducir la mortalidad neonatal relacionada con infección. No existen revisiones sistemáticas que exploren la eficacia de esta intervención. Objetivo. Evaluar la eficacia y seguridad de la limpieza corporal total con clorhexidina en la prevención de las infecciones asociadas al cuidado de la salud en neonatos de alto riesgo hospitalizados en cuidado intensivo neonatal. Metodología. Se realizó una revisión sistemática de la literatura. La búsqueda se hizo a través de las bases de datos Medline, Embase, LilaCS, Cochrane library y el registro de ensayos clínicos del Instituto Nacional de Salud de Estados Unidos. Se incluyeron ensayos clínicos publicados en los últimos 15 años hasta el 30 de enero del 2015. Las variables cualitativas se estimaron mediante OR o RR con sus IC95%. Las variables cuantitativas mediante diferencias de promedios o diferencias estandarizadas de promedios con sus IC95%. Resultados: Se incluyeron 3 estudios en el análisis cualitativo y cuantitativo. No se encontró evidencia concluyente que permita recomendar el uso de la limpieza corporal total con clorhexidina en los recién nacidos hospitalizados en cuidado intensivo neonatal. Conclusión: No existe evidencia que permita concluir que la limpieza corporal total con clorhexidina al 0.25% es mejor respecto a otras intervenciones en la prevención de sepsis neonatal asociada al cuidado de la salud . Es una intervención segura sin efectos adversos significativos. Background: Neonatal mortality is mainly due to infectious processes and prematurity. It has been suggested that whole body washing with chlorhexidine could reduce neonatal mortality associated with infection. No systematic reviews that allow exploring the efficacy of this intervention. Objective: To evaluate the efficacy and safety of total body cleansing with chlorhexidine in preventing infections related with health care in high risk neonates hospitalized in intensive care units. Methodology: A systematic review of the literature was performed. The search was performed trough Medline , Embase , Lilacs , Cochrane library databases and registration of clinical trials at the National Institute of Health. We included clinical trials published in the last 15 years until January 30 , 2015. Qualitative variables were estimated by OR or RR with 95% CI. Quantitative variables by mean differences or standardized mean differences with 95% CI . Results: Three studies were included in the qualitative and quantitative analysis. No conclusive evidence to recommend the use of total body cleansing with chlorhexidine in infants hospitalized in neonatal intensive care was found. Conclusión: There is no evidence to conclude that the total body washing with chlorhexidine to 0. 25% is better compared to other interventions in the prevention of infections associated with health care of high risk neonatal patient hospitalized in neonatal intensive care. It is a safe procedure without significant adverse effects.
Details
- Language :
- Spanish; Castilian
- Database :
- OpenAIRE
- Journal :
- Lawn J, Cousens S, Bhutta Z, al e. Why are 4 million newborn babies dying each year? Lancet. 2004; 364: p. 399–401., Black R, Cousens S, Johnson H, al e..; Child Health Epidemiology Reference Group of WHO and UNICEF. Global, regional, and national causes of child mortality in 2008: a systematic analysis. Lancet. 2010; 375: p. 1969–1987., Haines A, Cassels A. Can the millennium development goals be attained? BMJ. 2004; 329: p. 394–397, Auriti C. Risk factors for nosocomial infections in a neonatal intensive-care unit. Journal of Hospital infections. 2003; 53(1): p. 25-30., Borghesi A, Stronati M. Strategies for the prevention of hospital-acquired infections in the neonatal intensive care unit. Journal of Hospital infections. 2008; 68: p. 293-300., Corrales I, Álvarez M, Cortes J. Impacto de una intervención de precauciones de contacto sobre la infección intrahospitalaria en una unidad neonatal. Bogotá: Fundación Cardioinfantil-Universidad del Rosario, Unidad De Cuidados Intensivos Neonatales ; 2010., Andersen C, Hart J, Vemgal P, al e. Prospective evaluation of a multi-factorial prevention strategy on the impact of nosocomial infection in very-lowbirthweightinfants. Journal of Hospital Infections. 2005; 61: p. 162–7., Polin R, Denson S, Brady M. Strategies for prevention of health careassociated infections in the NICU. Pediatrics. 2012; 129: p. e1085–93, Sherman M. New concepts of microbial translocation in the neonatal intestine: mechanisms and prevention. Clinical Perinatology. 2010; 37(3): p. 565-79., Rotimi V, Olowe S, Ahmed I. The development of bacterial flora of premature neonates. J Hyg (Lond). 1985; 94(3): p. 309-18., Madan J, Farzan S, Hibberd P, Karagas M. Normal neonatal microbiome variation in relation to environmental factors, infection and allergy. Curr Opin Pediatr. 2012; 24(6): p. 753-9., Yatsunenko T, Rey F, Manary M, Trehan I, Dominguez-Bello M, Contreras M, et al. Human gut microbiome viewed across age and geography. Nature. 2012; 486: p. 222-7., Fernandez P, Dolinger E, Abdallah V, Resende D, Gontijo Filho P, Brito D. Late onset sepsis and intestinal bacterial colonization in very low birth weight infants receiving long-term parenteral nutrition. Rev Soc Bras Med Trop. 2011; 44(4): p. 447-50., Carl M, Ndao I, Springman A, Manning S, Johnson J, Johnston B, et al. Sepsis from the gut: the enteric habitat of bacteria that cause late-onset neonatal bloodstream infections. Clin Infect Dis. 2014; 58(9): p. 1211-8., Capone K, Dowd S, Stamatas G, Nikolovski J. Diversity of the human skin microbiome early in life. J Invest Dermatol. 2011; 131(10): p. 2026-32., Visscher M, Chatterjee R, Munson K, Pickens W, Hoath S. Changes in diapered and nondiapered infant skin over the first month of life. Pediatr Dermatol. 2000; 17(1): p. 45-51., Harpin V, Rutter N. Barrier properties of the newborn infant's skin. J Pediatr. 1983; 102(3): p. 419-25., Powers R, Wirtschafter D. Decreasing Central Line Associated Bloodstream Infection in Neonatal Intensive Care. Clinical Perinatology. 2010; 37: p. 247–27., Sankar J, Vinod P. Efficacy and Safety of Whole Body Skin Cleansing With Chlorhexidine in Neonates—A Systemic Review. Pediatric Infectious Journal. 2013; 32(6)., Pereira L, Chipato T, Mashu A, al e. Randomized study of vaginal and neonatal cleansing with 1% chlorhexidine. International Journal of Gynecology and obstetrics. 2011; 112: p. 234–238., Milstone A, Elward A, X S. Daily chlorhexidine bathing to reduce bacteremia in critically ill children: a multicentre, cluster-randomised, crossover trial. Lancet. 2013; 381., Sola A. Cuidados neonatales. Edimed. 2011; 519-535., JD S. Healthcare Infection Control Practices Advisory Committee. [Online].; 2007 [cited 2015 enero 2. Available from: www.cdc.gov/ncidod/dhqp/pdf/guidelines/ Isolation1007.pdf., Wynn J. Pathophysiology and Treatment of Septic Shock in Neonates. Clinical perinatology. 2010; 37: p. 439–479., Stronati M, Bollani L. Neonatal sepsis: new preventive strategies. Minerva Pediatrica. 2013; 65(1): p. 103-10., Borghesi A, Tzialla C. New possibilities of prevention of infection in the newborn. Journal of maternal-fetal and neonatal medicine. 2011; 24(Supple 2): p. 28-30., Saiman L. Strategies for prevention of nosocomial sepsis in the neonatal intensive care unit. Current Opinion of Pediatrics. 2006; 18(2): p. 101-6., Montes M, Ares S, Sola A. Recomendaciones de la Sociedad Iberoamericana de Neonatología (SIBEN). Consenso Utilización de soluciones antisépticas en recién nacidos. Bogotá:; 2008., Saleem S, Rouse D, McClure E, al e. Chlorhexidine vaginal and infant wipes to reduce perinatal mortality and morbidity: a randomized controlled trial. Obstet Gynecol. 2010; 115: p. 1225–1232., MJ S, Paul V, Kapil A, al. e. Does skin cleansing with chlorhexidine affect skin condition, temperature and colonization in hospitalized preterm low birth weight infants?: a randomized clinical trial. Journal of Perinatology. 2009; 29: p. 795–801., Enríquez DÁM, Barrero M. Guía de prevención, vigilancia epidemiológica y control de las infecciones asociadas al cuidado de la salud en las unidades de recién nacidos. Bogotá: Secretaria de salud; 2011., Coronel W. Sepsis Neonatal. Revista de enfermedades infecciosas en pediatría. 2009; 23., Vergnano S, Sharlad M. Neonatal Sepsis: an International Perspective. Arch Dis Child Fetal and Neonatal. 2005; 90: p. 220-224., Lawn J, Cousens S, Zupan J. 4 million neonatal deaths: when? Where? Why? Lancet. 2005; 365(9462): p. 891–900., Ayman A. Is Bloodstream Infection Preventable Among Premature Infants? A tale of two. Pediatrics. 2005; 115: p. 1513., Piantino J. Culture Negative Sepsis and Systemic Inflammatory Response Syndrome in neonates. Neonatal Reviews. 2013; 14: p. e294, Reyna-Figueroa J. Disparity in the criteria for including patients with neonatal sepsis in scientific medical studies. Are we swimming in a sea without limits? Anales de pediatria. 2006; 65(6): p. 536–540., Kilbride H, Wirtschafter D, Powers R, al. e. Implementation of evidence based potentially better practices to decrease nosocomial infections. Pediatrics. 2003; 111: p. e519–33., Bloom B, Craddock A, Delmore P, al e. Reducing acquired infections in the NICU: observing and implementing meaningful differences in processbetween high and low acquired infection rate centers. Journal of perinatology. 2003; 23: p. 489–92, Saiman L. Strategies for prevention of nosocomial sepsis in the neonatal intensive care unit. Current opinion in pediatrics. 2006; 18(2): p. 101-6., Shah P, Shah V. Continuous heparin infusion to prevent thrombosis and catheterocclusion in neonates with peripherally placed percutaneous central venous catheters. Cochrane database of systematic reviews. 2005., Rosemberg A, SD A, Delaware W, Peterseon A. Safety and efficacy of the antiseptic chlorhexidine gluconate. Sugery, Gynecology-obstetrics. 1976; 143., Chaiyakunapruk N, Veenstra D, Lipsky B, Saint S. Clorhexidine compared with povidone-iodine.solution for vascular catheter-site care: A meta-analysis. Annals of internal medicine. 2002; 136(11): p. 792-801., Bakr A, Karkour T. Effect of predelivery vaginal antisepsis on maternal and neonatal morbidity and mortality in Egypt. J Womens Health (Larchmt). 2005; 14: p. 496–50., Taha T, Biggar R, Broadhead R, al e.. Effect of cleansing the birth canal with antiseptic solution on maternal and newborn morbidity and mortality in Malawi: clinical trial. BMJ. 1997; 315: p. 216–219., Tamma P. Chlorhexidine use in the Neonatal Intensive Care Unit: Results from a National Survey. Infect Control Hosp Epidemiol. 2010; 31(8): p. 846–849., Mullany LC, Kahtry SK, Sherchand JB, LeClerq SC, Darmastadt GL, Katz J, Gauchan P, et al. Arandomizedcontrolled trial of theimpact of chlorhexidineskincleansingonbacterialcolonization of hospital-borninfants in Nepal. PediatricInfectDis J 2008; 27 (6): 505-511., Tielsch J, Darmstadt GL, Mullany LC, Khatry SK, Katz J, LeClerq SC, Shrestha S, et al. Impact of newbornskin-cleansingwithchlorexidineon neonatal mortlity in southern Nepal: a community-basedcluster-randomized trial. Pediatrics 2007; 119 (2): e330-e340., Darmstadt GL, Hossain M, Choi Y, Shirin M, Mullany LC, Islam M, Saha S. Safety and effect of chlorhexidineskincleansingonskin flora of neonates in Bangladesh. PediatricInfectDis J 2007; 26 (6): 492-495., Sankar MJ, Paul VK, Kapil A, Kalaivani M, Agarwal R, Darmstadt GI, Deorari AK. Doesskincleansingwithchlorexidineaffectskincondition, temperature and colonization in hospitalizedpretermlowbirthweightinfants?: A randomizedclinical trial. J Perinatol 2009; 29: 795-801., Gupta B, Das Vaswani N, Sharma D, Chaudhary U, Lekhwani S. Evaluation of efficacy of skincleansingwithclorhexidine in prevention of neonatal nosocomial sepsis-a randomizedcontrolled trial. J Matern Fetal Neonatal Med. En prensa., Chapman AK, Aucott SW, Milstone AM. Safety of chlorhexidine gluconate used for skin antisepsis in the preterm infant. J Perinatol 2012; 32 (1): 4-9., Imdad A, Bautista RM, Senen KA, Uy ME, Mantaring JB 3rd, Bhutta ZA. Umbilical cord antiseptics for preventing sepsis and death among newborns. Cochrane Database Syst Rev. 2013 May 31;5:CD008635, Sankar MJ, Paul VK. Efficacy and safety of whole body skin cleansing with chlorhexidine in neonates--a systemic review. Pediatr Infect Dis J 2013; 32( 6): e227-34., Garland JS, Alex CP, Mueller CD, et al. A randomized trial comparing povidone-iodine to a chlorhexidine gluconate-impregnated dressing for prevention of central venous catheter infections in neonates. Pediatrics 2001; 107:1431–6., Repositorio EdocUR-U. Rosario, Universidad del Rosario, instacron:Universidad del Rosario
- Accession number :
- edsair.doi.dedup.....06418578423f1456e0aa0fe5791e99d7
- Full Text :
- https://doi.org/10.48713/10336_10635