Background: Late-onset infections (LOI) are a major cause of morbidity and mortality among patients in the neonatal intensive care unit (NICU). Gloving after hand hygiene may be a pragmatic approach to prevent infections that arise when healthcare workers' hands transmit pathogens to neonates.
Objective: To determine the feasibility of conducting a multicenter, open-labeled randomized controlled trial (RCT) to determine whether a protocol that requires healthcare workers (HCWs) in a level 3 NICU to wear non-sterile gloves plus hand hygiene reduces the occurrence of a late-onset infection, compared to hand hygiene alone.
Methods: In this single-center pilot study, we recruited neonates admitted to the McMaster Children's Hospital NICU from June 2017 to May 2018. The NICU was randomized to begin with the standard (control) arm for 6 months (June 2017 to Dec 2017), followed by the gloving (GloveCare) arm for 6 months (Jan 2018 to July 2018), with a 2-week washout period in-between to educate healthcare workers about gloving. We measured numerous feasibility outcomes including enrollment, event rate, and compliance with hand hygiene (Moment 1: before patient contact, Moment 2: before clean procedure, Moment 3: after body fluid contact, Moment 4: after patient contact) and gloving compliance.
Results: We enrolled 750 neonates (390 Standard care, 360 GloveCare) and achieved 100% enrollment. We found higher hand hygiene compliance during the standard care arm compared to the GloveCare for all four moments of hand hygiene (Moment 1: 87% vs 79%, OR=1.86 (1.34, 2.59); Moment 2: OR=1.73 (1.00, 3.01); Moment 3: OR=1.11 (0.62, 1.98); Moment 4: OR=1.65 (1.27, 2.14)). We developed and validated a method to calculate glove compliance, which ranged from 48 to 85%, and was highest for moment 3 (doffing after a procedure or body fluid exposure risk). No adverse events were documented for patients or staff.
Discussion: Reduction in hand hygiene compliance in the GloveCare arm presents a pragmatic challenge in ascertaining the effectiveness of gloving to prevent LOI. Most LOIs were non-sterile-site infections, which is considered a less patient-important or clinically relevant outcome compared to sterile-site LOI. Ensuring efficient collection and validation of hand hygiene and gloving data is imperative.
Conclusion: The pilot study demonstrated the feasibility of this intervention though modifications to improve hand hygiene compliance during GloveCare will be important prior to a multicenter cluster RCT to assess the efficacy of non-sterile glove-based care in preventing LOI in the NICU.
Trial Registration: Clinicaltrials.gov, NCT03078335.
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http://dx.doi.org/10.1186/s40814-023-01271-9 | DOI Listing |
PLoS One
January 2025
Department of Preventive Medicine, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia.
Background: Despite the rising prevalence of common mental symptoms, information is scarce on how health workers make sense of symptoms of mental disorders and perceive a link with inadequate water, sanitation, and hygiene (WASH) as work stressors to understand causation and produce useful knowledge for policy and professionals. Therefore, this study aimed to explore how health workers perceive the link between inadequate WASH and common mental symptoms (CMSs) at hospitals in central and southern Ethiopian regions.
Methods: We used an interpretive and descriptive phenomenological design guided by theoretical frameworks.
Nat Commun
January 2025
University of California, Santa Cruz, Santa Cruz, CA, USA.
Antibiotics can trigger antimicrobial resistance and microbiome alterations. Reducing pathogen exposure and undernutrition can reduce infections and antibiotic use. We assess effects of water, sanitation, handwashing (WSH) and nutrition interventions on caregiver-reported antibiotic use in Bangladesh and Kenya, longitudinally measured at three timepoints among birth cohorts (ages 3-28 months) in a cluster-randomized trial.
View Article and Find Full Text PDFJ Hosp Infect
January 2025
Infectious Diseases, Department of Internal Medicine I, University Hospital Tübingen, Tübingen, Germany; Infectious Diseases, Dept of Diagnostic and Public Health, University Hospital Verona, Verona, Italy; DZIF-Clinical Research Unit, Infectious Diseases, Department of Internal Medicine I, University Hospital Tübingen, Tübingen, Germany.
Background: ESBL-producing Enterobacterales (ESBL-PE) are highly prevalent in long-term healthcare (LTCF) settings. In order to estimate the acquisition rate of ESBL-producing Escherichia coli and Klebsiella pneumoniae in LTCF settings and identify clinical and environmental risk factors, a multicentric, prospective cohort study was conducted in six LTCFs in Germany, France, Spain and the Netherlands.
Methods: Longitudinal screening of residents was performed over 32 weeks, collecting epidemiological and clinical data and environmental samples.
J Nutr
January 2025
Department of Nutrition and Food Hygiene, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou 510515, China. Electronic address:
Background: Nutritional factors are important for skeletal muscle mass and grip strength development in children.
Objective: This study aimed to investigate the relationship between erythrocyte membrane fatty acid patterns and skeletal muscle mass and grip strength in children.
Methods: A total of 452 children aged 6-9 years were included in this study.
Noise Health
January 2025
Institute of Hygiene and Medical Ecology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
Exposure to sound energy may be a risk factor or a therapeutic intervention for Alzheimer's disease (AD). On one hand, noise has a harmful effect on people with AD by contributing to hearing loss, sleep disturbance, oxidative stress, inflammation, and excitotoxicity. But on the other hand, clinical trials and nursing home interventions with soundscape augmentation involving natural sounds have shown promising results in alleviating psychophysiological symptoms in people with AD.
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