NeoCLEAN: a multimodal strategy to enhance environmental cleaning in a resource-limited neonatal unit.
NeoCLEAN: a multimodal strategy to enhance environmental cleaning in a resource-limited neonatal unit.
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DOI：
10.1186/s13756-021-00905-y
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发表时间：
2021-02-12
影响因子：
5.5
通讯作者：
Coffin S
中科院分区：
文献类型：
--
作者：
Dramowski A;Aucamp M;Bekker A;Pillay S;Moloto K;Whitelaw AC;Cotton MF;Coffin S
医院环境污染导致新生儿细菌定植和感染。在资源有限的情况下，很少对医院表面和设备的清洁进行审计。在一个有30张病床的新生儿病房中，进行了一项准实验研究，以评估多模式清洁干预对表面和设备的影响。干预措施包括通过反馈进行清洁审计、清洁清单、室内清洁湿巾以及对工作人员和母亲进行清洁方法培训。使用定量细菌表面培养、三磷酸腺苷生物发光分析和荧光紫外线标记物对100项物品(58个表面，42台设备)的清洁充分性进行了评估，分别在基线(P1,2019年10月)、早期干预(P2,2019年11月)和晚期干预(P3,2020年2月)进行。环境拭子(55/300；18.3%)检出78株潜在新生儿病原菌，以肠球菌、粘质葡萄球菌、肺炎克雷伯菌、金黄色葡萄球菌和鲍曼不动杆菌为主。从水槽、牛奶厨房表面、加湿器和吸管等潮湿表面观察到的需氧菌落数最高。无细菌生长的表面和设备的比例在各阶段之间增加(P1 = 49%，P2 = 66%，P3 = 69%；p = 0.007)。达到atp“清洁度”阈值的表面和设备的比例(<； 200相对光单位)随着时间的推移而增加(P1 = 40%，P2 = 54%，P3 = 65%；p = 0.002)，UV标记去除率也增加(P1 = 23%，P2 = 71%，P3 = 74%；p <； 0.001)。新生儿病房的常规环境清洁在基线时是次优的，但在多模式清洁干预后显着改善。让母亲和护理人员参与是在这个资源有限的新生儿病房实现改善环境和设备清洁的关键。网上版载有补充材料，可在10.1186/s13756-021-00905-y查阅。
Contamination of the hospital environment contributes to neonatal bacterial colonization and infection. Cleaning of hospital surfaces and equipment is seldom audited in resource-limited settings. A quasi-experimental study was conducted to assess the impact of a multimodal cleaning intervention for surfaces and equipment in a 30-bed neonatal ward. The intervention included cleaning audits with feedback, cleaning checklists, in-room cleaning wipes and training of staff and mothers in cleaning methods. Cleaning adequacy was evaluated for 100 items (58 surfaces, 42 equipment) using quantitative bacterial surface cultures, adenosine triphosphate bioluminescence assays and fluorescent ultraviolet markers, performed at baseline (P1, October 2019), early intervention (P2, November 2019) and late intervention (P3, February 2020). Environmental swabs (55/300; 18.3%) yielded growth of 78 potential neonatal pathogens with Enterococci, S. marcescens, K. pneumoniae, S. aureus and A. baumannii predominating. Highest aerobic colony counts were noted from moist surfaces such as sinks, milk kitchen surfaces, humidifiers and suction tubing. The proportion of surfaces and equipment exhibiting no bacterial growth increased between phases (P1 = 49%, P2 = 66%, P3 = 69%; p = 0.007). The proportion of surfaces and equipment meeting the ATP “cleanliness” threshold (< 200 relative light units) increased over time (P1 = 40%, P2 = 54%, P3 = 65%; p = 0.002), as did the UV marker removal rate (P1 = 23%, P2 = 71%, P3 = 74%; p < 0.001). Routine environmental cleaning of this neonatal ward was sub-optimal at baseline but improved significantly following a multimodal cleaning intervention. Involving mothers and nursing staff was key to achieving improved environmental and equipment cleaning in this resource-limited neonatal unit. The online version contains supplementary material available at 10.1186/s13756-021-00905-y.
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影响因子：
3.2
作者：
Gon, Giorgia;Ali, Said M.;Graham, Wendy J.
通讯作者：
Graham, Wendy J.
影响因子：
3.6
作者：
Golan, Y;Doron, S;Snydman, DR
通讯作者：
Snydman, DR
影响因子：
3
作者：
Oza, Hemali Harish;Fisher, Michael Benjamin;Bartram, Jamie
通讯作者：
Bartram, Jamie
影响因子：
11.8
作者：
Mwananyanda, Lawrence;Pierre, Cassandra;Hamer, Davidson H.
通讯作者：
Hamer, Davidson H.
DOI：
10.1186/s40748-017-0043-3
发表时间：
2017
期刊：
Maternal health, neonatology and perinatology
影响因子：
--
作者：
Ramasethu J
通讯作者：
Ramasethu J