Infection control strategies in a neonatal intensive care unit in Argentina

An intervention strategy was designed to reduce the high endemic rates of nosocomial bacteraemia in a neonatal intensive care unit (NICU) in Argentina where no changes can be expected in the ratio of patients to nurses. After surveillance of high-risk procedures, guidelines were developed by physician and nurse consensus, based on CDC guidelines and adapted to actual circumstances for handwashing, handling of infants, care of intravenous lines and suction of endotracheal tubes. These guidelines were taught to all involved personnel and made effective on July 1, 1995. Data from blood cultures obtained after 72 h of life and on patient-days in the unit were collected for 1 year periods before (P1), and, after (P2) this intervention strategy was instituted. During P1, the overall bacteraemia rate was 20/1000 patient-days, and the Gram-negative bacteraemia rate was 7.7/1000 patient-days but bacteraemia and Gram-negative bacteraemia rates dropped to 12.4 and 2.2/1000 patient-days respectively (P < 0.003) during P2. We conclude that simple intervention strategies such as the one developed at our institution can reduce rates of nosocomial infection.