Cochrane · systematic review · CD013326
Hand hygiene for the prevention of infections in neonates
Kuti, BP, Ogunlesi, TA, Oduwole, O, et al. · Cochrane Database of Systematic Reviews · 2023 · Cochrane Library
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
10
current version
GRADE rated
6
No studies
4
Included studies
NR
No studies 4 · 40%Ungraded 0 · 0%Very low 5 · 50%Low 0 · 0%Moderate 1 · 10%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Current version onlyTwo per cent CHG compared to alcohol hand sanitiser (61% alcohol and emollients) for the prevention of infections in neonates
Population: Neonates and caregivers
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Incidence of (author‐defined) suspected infections within the first 28 days of life Two per cent CHG vs alcohol hand sanitiser (61% alcohol and emollients) | no estimate extracted | NR | No studies |
Incidence of bacteriologically confirmed infections (types of infection as specified by authors) within the first 28 days of life Two per cent CHG vs alcohol hand sanitiser (61% alcohol and emollients) | RR 0.79 [0.66, 0.93] | 1 study · 2932 participants | Moderate Downgraded: risk of bias |
All‐cause mortality within the first seven days of life (early neonatal death) Two per cent CHG vs alcohol hand sanitiser (61% alcohol and emollients) | no estimate extracted | NR | No studies |
All‐cause mortality from the 8th to 28th day of life (late neonatal death) Two per cent CHG vs alcohol hand sanitiser (61% alcohol and emollients) | no estimate extracted | NR | No studies |
Alcohol‐based handrub compared to usual care for the prevention of infections in neonates
Population: Neonates and caregivers
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Incidence of suspected infections (author‐defined) within the first 28 days of life Alcohol‐based handrub vs usual care | RR 0.98 [0.69, 1.39] | 1 study · 103 participants | Very low Downgraded: imprecision, indirectness |
Incidence of bacteriologically confirmed infections within the first 28 days of life Alcohol‐based handrub vs usual care | no estimate extracted | NR | No studies |
All‐cause mortality within the first seven days of life (early neonatal death) Alcohol‐based handrub vs usual care | RR 0.29 [0.01, 7] | 1 study · 103 participants | Very low Downgraded: imprecision, indirectness |
All‐cause mortality from the 8th to 28th day of life (late neonatal death) Alcohol‐based handrub vs usual care | RR 0.29 [0.01, 7] | 1 study · 103 participants | Very low Downgraded: imprecision, indirectness |
Four per cent chlorhexidine + hand hygiene promotion compared to usual care for prevention of infections in neonates
Population: Neonates and caregivers
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Authors reported adverse outcomes (events without hospitalisation) Four per cent chlorhexidine + hand hygiene promotion vs usual care | RR 0.57 [0.28, 1.15] | 1 study · 246 participants | Very low Downgraded: risk of bias |
Adverse events requiring hospitalisation (SAE) Four per cent chlorhexidine + hand hygiene promotion vs usual care | RR 1.83 [0.75, 4.42] | 1 study · 246 participants | Very low Downgraded: risk of bias |
2% chlorhexidine gluconate (CHG) compared to alcohol hand sanitiser (61% alcohol and emollients) for prevention of infection in neonates
Population: prevention of infection in neonates
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Incidence of (study author‐defined) suspected infection within the first 28 days of life 2% chlorhexidine gluconate (CHG) vs alcohol hand sanitiser (61% alcohol and emollients) | no estimate extracted | NR | No studies |
Incidence of bacteriologically confirmed infection (types of infection as specified by study authors) within the first 28 days of life ‐ all infections 2% chlorhexidine gluconate (CHG) vs alcohol hand sanitiser (61% alcohol and emollients) | RR 2.19 [1.79, 2.69] | 1 study · 2932 participants | Very low Downgraded: risk of bias |
All‐course mortality within the first 7 days of life (early neonatal death) 2% chlorhexidine gluconate (CHG) vs alcohol hand sanitiser (61% alcohol and emollients) | no estimate extracted | NR | No studies |
All‐cause mortality from the 8th to the 28th day of life (late neonatal death) 2% chlorhexidine gluconate (CHG) vs alcohol hand sanitiser (61% alcohol and emollients) | no estimate extracted | NR | No studies |
Duration of hospital stay 2% chlorhexidine gluconate (CHG) vs alcohol hand sanitiser (61% alcohol and emollients) | no estimate extracted | NR | No studies |
Incidence of community‐acquired infection and hospital‐acquired infection 2% chlorhexidine gluconate (CHG) vs alcohol hand sanitiser (61% alcohol and emollients) | no estimate extracted | NR | No studies |
Adverse events (higher score is better) ‐ mean observers reported skin changes in nurses (mean score) 2% chlorhexidine gluconate (CHG) vs alcohol hand sanitiser (61% alcohol and emollients) | no estimate extracted | 1 study · 120 participants | Very low Downgraded: risk of bias |
4% chlorhexidine gluconate (CHG) compared to plain liquid soap for prevention of infection in neonates
Population: nurses and neonates
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Adverse outcome (higher score is better) ‐ mean visual scoring of skin (mean score) 4% chlorhexidine gluconate (CHG) vs plain liquid soap | no estimate extracted | 1 study · 16 participants | Very low Downgraded: risk of bias |
Adverse outcome (higher score is better) ‐ mean hand self‐assessment (mean score) 4% chlorhexidine gluconate (CHG) vs plain liquid soap | no estimate extracted | 1 study · 16 participants | Very low Downgraded: risk of bias |
Incidence of bacteriologically confirmed infection within the first 28 days of life 4% chlorhexidine gluconate (CHG) vs plain liquid soap | no estimate extracted | NR | No studies |
Incidence of (study author‐defined) suspected infection within the first 28 days of life 4% chlorhexidine gluconate (CHG) vs plain liquid soap | no estimate extracted | NR | No studies |
All‐cause mortality within the first 7 days of life (early neonatal death) 4% chlorhexidine gluconate (CHG) vs plain liquid soap | no estimate extracted | NR | No studies |
All‐cause mortality from the 8th to the 28th day of life (late neonatal death) 4% chlorhexidine gluconate (CHG) vs plain liquid soap | no estimate extracted | NR | No studies |
Duration of hospital stay 4% chlorhexidine gluconate (CHG) vs plain liquid soap | no estimate extracted | NR | No studies |
Any hospitalisation for neonates managed in the community setting 4% chlorhexidine gluconate (CHG) vs plain liquid soap | no estimate extracted | NR | No studies |
Chlorhexidine gluconate 4% compared to triclosan 1% for prevention of infection in neonates
Population: prevention of infection in neonates
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Incidence of suspected new infection Chlorhexidine gluconate 4% vs triclosan 1% | RR 1.04 [0.19, 5.6] | 1 study · 1916 participants | Very low Downgraded: risk of bias |
Total incidence of new infection (bacteriologically confirmed) Chlorhexidine gluconate 4% vs triclosan 1% | RR 6.01 [3.56, 10.14] | 1 study · 1916 participants | Very low Downgraded: risk of bias |
All‐cause mortality within the first 7 days of life (early neonatal death) Chlorhexidine gluconate 4% vs triclosan 1% | no estimate extracted | NR | No studies |
All‐cause mortality from the 8th to the 28th day of life (late neonatal death) Chlorhexidine gluconate 4% vs triclosan 1% | no estimate extracted | NR | No studies |
Duration of hospital stay ‐ not measured Chlorhexidine gluconate 4% vs triclosan 1% | no estimate extracted | NR | No studies |
Incidence of community‐acquired and hospital‐acquired infection Chlorhexidine gluconate 4% vs triclosan 1% | no estimate extracted | NR | No studies |
Study author‐reported adverse events Chlorhexidine gluconate 4% vs triclosan 1% | no estimate extracted | 1 study · 1916 participants | Very low Downgraded: risk of bias |