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005			20200922112829.0
008			200520t ph |||p| |||| 00| 0|eng|d
040			_aDOH _cDOH
245	0	0	_aImpact of enhanced infection control at 2 neonatal intensive care units in the Philippines / _cChristopher J. Gill [and seven others]
520	3		_aBackground. The growing burden of neonatal mortality associated with hospital-acquired neonatal sepsis in the developing world creates an urgent need for cost-effective infection-control measures in resource-limited settings. Methods. Using a before-and-after comparison design, we measured how rates of staff hand-hygiene compliance, colonization with drug-resistant pathogens (defined as ceftazidime- and/or gentamicin-resistant gram-negative bacilli and drug-resistant gram-positive cocci), bacteremia, and overall mortality changed after the introduction of a simplified package of infection-control measures at 2 neonatal intensive care units (NICUs) in Manila, The Philippines. Results. Of all 1827 neonates admitted to the NICU, 561 (30.7%) arrived from delivery already colonized with drug-resistant bacteria. Of the 1266 neonates who were not already colonized, 578 (45.6%) became newly colonized with drug-resistant bacteria. Of all 1827 neonates, 358 (19.6%) became bacteremic (78.2% were infected with gram-negative bacilli) and 615 (33.7%) died. Of 2903 identified drug-resistant colonizing bacteria, 85% were drug-resistant gram-negative bacilli (predominantly Klebsiella species, Pseudomonas species, and Acinetobacter species) and 14% were methicillin-resistant Staphylococcus aureus. Contrasting the control period with the intervention period at each NICU revealed that staff hand-hygiene compliance improved (NICU 1: relative risk, 1.3; 95% confidence interval 1.1–1.5; NICU 2: relative risk, 1.6; 95% confidence interval, 1.4–2.0) and that overall mortality decreased (NICU 1: relative risk, 0.5; 95% confidence interval, 0.4–0.6; NICU 2: relative risk, 0.8; 95% confidence interval, 0.7–0.9). However, rates of colonization with drug-resistant pathogens and of sepsis did not change significantly at either NICU. Discussion. Nosocomial transmission of drug-resistant pathogens was intense at these 2 NICUs in The Philippines; transmission involved mostly drug-resistant gram-negative bacilli. Infection-control interventions are feasible and are possibly effective in resource-limited hospital settings. _uhttps://pubmed.ncbi.nlm.nih.gov/19025496/
580			_aIn: Clinical Infectious Disease, 2009 vol. 48 (1) pages 13-21
650		2	_aAnti-Bacterial Agents _xpharmacology
650		2	_aBacteria _xisolation and purification
650		2	_a Bacterial Infections _xprevention and control
650		2	_aCross Infection _xprevention and control
650		2	_aInfant, Newborn
650		2	_aSepsis _xprevention and control
650		2	_a Intensive Care Units, Neonatal
700	1		_aGill, Christopher J.
700	1		_aMantaring, Jose B. V.
700	1		_aMacleod, William B.
700	1		_aMendoza, Myrna
700	1		_aMendoza, Sookee
700	1		_aHuskins, W. Charles
700	1		_aGoldmann, Donald A.
700	1		_aHamer, Davidson H.
856			_uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3866590/
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999			_c570 _d570