{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,16]],"date-time":"2026-05-16T03:17:04Z","timestamp":1778901424951,"version":"3.51.4"},"reference-count":32,"publisher":"BMJ","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arch Dis Child Fetal Neonatal Ed"],"published-print":{"date-parts":[[2004,7]]},"abstract":"<jats:p>\n                  <jats:bold>Objective:<\/jats:bold> To assess the incidence of late onset (&gt;\u00a072 hours) infection and necrotising enterocolitis (NEC) in very low birthweight (VLBW) infants in two 36 month periods using two hand hygiene protocols: conventional handwashing (HW; first 36 month period); an alcohol hand rub and gloves technique (HR; second 36 month period).<\/jats:p>\n               <jats:p>\n                  <jats:bold>Method:<\/jats:bold> VLBW infants admitted to the neonatal intensive care unit during the period December 1993\u2013November 1999 were eligible. A new hand hygiene protocol using alcohol handrub and gloves was introduced in December 1996. Each patient\u2019s case record was reviewed retrospectively by two independent investigators using a standard data collection form. The incidence of NEC and systemic infections, including bacterial or fungal septicaemia, meningitis, and peritonitis, in the two periods were compared.<\/jats:p>\n               <jats:p>\n                  <jats:bold>Results:<\/jats:bold> The HW and HR groups contained 161 and 176 VLBW infants respectively. The incidence of late onset systemic infection decreased from 13.5 to 4.8 episodes (including NEC)\/1000 patient days after introduction of the HR regimen, representing a 2.8-fold reduction. Similarly, the incidence of Gram positive, Gram negative, and fungal infections decreased 2.5-fold, 2.6-fold, and 7-fold respectively. There was also a significant reduction in the incidence of NEC in the HR group (p\u00a0&lt;\u00a00.0001). Subgroup analysis revealed that the incidence of methicillin resistant <jats:italic>Staphylococcus aureus<\/jats:italic> (MRSA) septicaemia was significantly decreased in the second 36 month period (p\u00a0\u200a=\u200a\u00a00.048). The clinical data suggest that infants in the HW group had significantly earlier onset of sepsis (p\u00a0&lt;\u00a00.05) and required oxygen supplementation for longer (p\u00a0&lt;\u00a00.05) than those in the HR group. Significantly more VLBW infants were discharged from the neonatal intensive care unit without ever being infected (p\u00a0&lt;\u00a00.0001), and also significantly fewer infants had more than one episode of infection in the HR group (p\u00a0&lt;\u00a00.0001).<\/jats:p>\n               <jats:p>\n                  <jats:bold>Conclusion:<\/jats:bold> The introduction of the HR protocol was associated with a 2.8-fold reduction in the incidence of late onset systemic infection, and also a significant decrease in the incidence of MRSA septicaemia and NEC in VLBW infants. This decrease in infection rate was maintained throughout the second 36 month period.<\/jats:p>","DOI":"10.1136\/adc.2003.031104","type":"journal-article","created":{"date-parts":[[2004,6,21]],"date-time":"2004-06-21T19:43:09Z","timestamp":1087846989000},"page":"F336-F340","source":"Crossref","is-referenced-by-count":63,"title":["Combined use of alcohol hand rub and gloves reduces the incidence of late onset infection in very low birthweight infants"],"prefix":"10.1136","volume":"89","author":[{"given":"P C","family":"Ng","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H L","family":"Wong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D J","family":"Lyon","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K W","family":"So","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"F","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R K Y","family":"Lam","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E","family":"Wong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A F B","family":"Cheng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"T F","family":"Fok","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2004,6,21]]},"reference":[{"key":"2025090514391357000_89.4.F336.1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.110.2.285"},{"key":"2025090514391357000_89.4.F336.2","doi-asserted-by":"publisher","DOI":"10.1097\/00006454-200001000-00012"},{"key":"2025090514391357000_89.4.F336.3","doi-asserted-by":"publisher","DOI":"10.1080\/080352598750031392"},{"key":"2025090514391357000_89.4.F336.4","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1111\/j.1440-1754.1996.tb00914.x","volume":"32","year":"1996","journal-title":"J Paediatr Child Health"},{"key":"2025090514391357000_89.4.F336.5","doi-asserted-by":"publisher","DOI":"10.1016\/0196-6553(89)90002-3"},{"key":"2025090514391357000_89.4.F336.6","first-page":"28","volume":"9","year":"1998","journal-title":"Infect Control Hosp Epidemiol"},{"key":"2025090514391357000_89.4.F336.7","unstructured":"Rotter ML. 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