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Impact of changing the skin disinfectant on the hospital-infection rate in a NICU

Maria Teresa Neto1,2 , Micaela Serelha2.

1 - NOVA Medical School/Faculdade de Ciências Médicas
2 - Neonatal Intensive Care Unit. Hospital de Dona Estefânia. Centro Hospitalar de Lisboa Central, EPE, Lisboa

XLV Jornadas Nacionais de Neonatologia.- Comunicação oral

Resumo: For years disinfectant used in the NICU and in the operating theatre was polyvidone-iodine. From December 2014 we moved to octenidine®.
Aim - To evaluate if the changing to a new skin disinfectant influenced the rate of hospital infection.
Methods - Data collected from the National Registry of HCAI in NICU – DGS. All episodes of infection were included: clinical sepsis with positive or negative blood culture; CVC- related infection and infection in newborns without CVC. Success measures: rate of hospital infection; expenditure of all antibiotics; expenditure of vancomycin, 2015 compared with 2014.
Results – In 2015 there were lower number of discharged patients and number of in-hospital days but the percentage of patients in intensive care (IC) and the percentage of time in IC were similar. CVC and TT utilization ratio were also lower. In 2015 the rate of infected patients (9%) (p<0.008) and the incidence of hospital infection (5.7/1000 admission days) were lower. Infection in VLBW infants (p=0.54) and in patients operated on (p=0.724) were similar; sepsis in patients with CVC (7.4/1000 CVC days) and CVC–related sepsis (0.7/1000 CVC days) were significantly lower. CoNS sepsis in VLBW infants (p=0.049) and surgical site infection rate were also lower (p<0.09 for patients operated on and 0.06 for the number of surgeries.). A decrease in the use of all antibiotics and vancomycin was found (p<0.0038 and p< 0.038 respectively).
Conclusion – There is a trend to lower rates of infection and expenditure of antibiotics associated with the changing to octenidine®. 

Palavras-Chave: Neonatal Intensive Care Units, Nosocomial infection, Skin disinfectant