Infection - Skin to Skin Contact

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Infection
Abouelfettoh et al., 2010
Anderson et al., 2003
AWHONN, 2008?
Bauer, Sontheimer,et al., 1996
Cerezo & deLeon, 1992
Charpak et al., 1997
Charpak et al., 2001
Clarke, 2009
Conde-Agudelo et al., 2000b
Conde-Agudelo et al., 2003
Conde-Agudelo et al.,2007
Crenshaw et al., 2004
Darmstadt et al., 2000
Mendes & Procianoy, 2008,09
Filho et al. 2008
Gangal, 2007
Gottesman,2009
Gupta et al., 2007
Hall & Kirsten, 2008
Hendricks-Munoz, 2002
Heyns et al., 2006
Jeanette et al. 2004
Kadam et al., 2005
Kambarami 2002
Updated: 5/19/10
PT, descriptive study of 5 days of KC effects on skin hydration
(increased) and TEWL (increased) and # of infections during
hospitalization and within one month of discharge (no infections after
KC).
Meta-Analysis showed KC associated with fewer nosocomial infections
Positive benefits of KC include decreased incidence and severity of
Infection., pg. 243.
PT, VLBW, infection rate measured with maternal and paternal KC
I think this is a descriptive study but I have to read it again
No sig diff by blood cultures and no sig diff in other cultures
PT, RCT, # & proportion of infectious episodes that had to be treated
during hospitalization was same, proportion of nosocomial infections
after eligibility and before discharge was less in KMC (3.8%) than
controls (7.8%, p=0.026)(pg. 685). Number of total infectious episodes
that had to be treated in hospital was lower in KC(7.6%, controls=
11%) but not sig. different.
PT , RCT, less infections in KMC at 1 year of age- secondary to BF
Rev of PT KC in developing countries and cites that KC has benefit of
fewer infections.
Just reporting that they will look at infection rate, no evidence to
support reduced infection in 24/7 KMC infants
Not meta-analysis results, but findings of the seven new studies they
examined are that infections decrease in KC group
PT, Cochrane Meta-analysis of 1362 24/7 KMC infants in 3 studies
(same as reported before). KMC infants are at less risk of nosocomial
infection and lower respiratory tract disease at 6 months.
Review of reasons why KC at birth is good, and reduction in infections
is one of the reasons for Lamaze’s support for normal birth position
paper
Review of how KC reduces infections and why it is important to use in
community settings to prevent infections in newborns
PT, VLBW RCT. KC was routine, standard care and infants who got
KC + massage had less infection than KC alone group.
PT, clin eval of 8 NICUs with KC stepdown vs 8 units without KC
stepdown. No difference in infections between units.
FT One step mentions “The baby’s risk of infection is reduced because
safe germs (bacteria) from the mother start to colonize her skin and
intestines, and prevent harmful germs from growing”(pg. 12)..
Quotes Dr.Ludington as saying KC reduces infections and this is for
consumers in MOTHERING magazine.
PT, descriptive of 50 infants getting 4-6 hrs/day til discharge. No
infections during KC.
PT review of sloan, charpak 97 & 01 showing decreased infections
PT, Clinical Report – “no evidence of increased risk of infection”
PT, 4/6 babies in KMC unit got TB from untreated TB active mother.
Review, says KC at birth helps prevent infection. Same as Crenshaw
ref
PT, RCT. # of sepsis in KMC =6, control =8. 6 KMC babies transferred
back to regular care due to klebsiella pneumoniae. One KMC baby died
from sepsis. Overall, no sig diff in sepsis incidence.
PT, chart review of 42 twins/2 triplets in 24/7 KC unit. 6 had to go to
NICU for sepsis, then returned to and discharged from KC unit
Kambarami et al, 1998
Kirsten & Kirsten 2000
Lawn et al., 2010
Mallet et al., 2007
Mendes & Procianoy 2009
Mendes & Procianoy, 2008
Odent, 1989
Rao et al., 2008
Sakaki et al., 2009
Schanler 2001
Schanler et al., 2005
Sizun et al., 2004
Sloan et al., 1994
Sosa et al., 1976
Visser et al., 2008
WHO 1998
PT, RCT, 37 KC (24/7 KC) infants “were ill less frequently” than 37
controls.
PT, RCT BF in KMC reduced incidence of nec (10% vs 2.8%)
Meta analysis of KMC. It is particularly effective in reducing severe
morbidity, particularly from infection.
PT, Descriptive study of French NICU staff knowledge and barriers.
Fear of nosocomial infection is a barrier to KC use.
PT, RCT, VLBW. Less infection in KC + massage group than in KC
alone group.
PT, RCT, VLBW. Less infection in KC+massage (4 times a day from
48 hours oflife until discharge) than KC alone infants.
FT, Clin Report- baby feeds at breast right after delivery in KC and
Gets lots of IgA antibodies and zinc and enzymes in colostrums.
PT, RCT, more controls than KMCers had nosocomial sepsis (p.19)
PT, Descriptive prospective study of incidence of MRSA among 961
infants. KMC was a predictor of MRSA.
PT, review article says that KC provides specific protection over
infection due to enteromammary pathway
PT, RCT, infants in mother’s own milk group (who also got
significantly more episodes and significantly more duration of KC than
preterm formula and donor milk groups) had fewer infection events
(late onset sepsis, UTI, meningitis, NEC), but KC per se was not
correlated to number of infection-related events.
States that KC has shown fewer infections in developing countries but
that these findings may not be relevant in high tech countries. Cites
Charpak et al., 2001 as source of infection data.
PT, RCT, decrease in severe infections such as pneumonia, septicemia
in KMC infants over first 6 months of life
In all 3 RCTs, FT infants who got 45 min of KC beginning after
episiotomy repair had fewer episodes of infection (moniliasis,
impetigo, and medicated illness).
PT, descriptive of 23 preterm infants who came down with nosocomial
RSV associated pneumonia one month after same strain appeared in
general pediatric ward of same hospital in Gauteng, South Africa.
Ft. states that when a mother and her baby are in KC the baby is
exposed to the normal bacterial on the mother’s skin, which may
protect the baby from becoming sick due to harmful germs.
Related Literature
Institute of Medicine, 2006 Report of Preterm Birth concludes that ‘stress’ and ‘infection’ contribute to the
racial/ethnic differences in infant mortality rate.
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