Aseptic technique did not reduce LOS in infants
Strict aseptic technique for parenteral nutrition (PN) line management did not significantly reduce the incidence of late-onset sepsis (LOS) in very low birth weight (VLBW) infants compared with standard technique, according to a recent study.
“The bundle of PN line management employing a two-nurse sterile technique and measures to reduce breaches of lines used to infuse the PN did not reduce the incidence of LOS in infants of <1500 g birth weight,” according to the researchers.
In this prospective randomized controlled trial, 249 infants (birth weight, <1500 g) were randomized to aseptic technique group (n=126) or standard technique group (n=123). [BMC Pediatrics 2017;doi:10.1186/s12887-017-0855-3]
There was no significant difference in sepsis outcomes in the aseptic technique group compared with the standard technique group (31.8 percent vs 29.3 percent; p=0.77). Majority of the sepsis episodes occurred during the first 28 days of life.
In a subgroup analysis for infants with birth weight of <1000 g, 45.9 percent (n=28) of participants in the aseptic technique group and 38.3 percent (n=23) in the standard technique group reported an episode of LOS.
“After adjustment for birth weight, receiving PN was the factor associated with the greatest risk,” said the researchers, which was consistent with previous studies that have implicated PN as an important risk factor for LOS. [Pediatr Infect Dis J 1998;17:10-17; Am J Perinatol 2015;32:675-682; Am J Infect Control 2001;29:109-114]
“The results of our study were unexpected and the reasons for the lack of effectiveness of the study intervention remain unclear. It is possible that awareness among staff in the NICU that management of PN lines may affect risk for LOS might have improved diligence with respect to management of all PN lines, affecting LOS incidence in the control group,” said the researchers.Given the lack of evidence to recommend aseptic technique as a routine practice, further research is recommended to evaluate other potentially effective methods in reducing LOS.