Patient isolation measures for infants with candida colonization or infection for preventing or reducing transmission of candida in neonatal units
- PMID: 22071827
- PMCID: PMC7389412
- DOI: 10.1002/14651858.CD006068.pub3
Patient isolation measures for infants with candida colonization or infection for preventing or reducing transmission of candida in neonatal units
Abstract
Background: Candida is a common nosocomial infection and is associated with increased healthcare costs. In neonates, candida infection is associated with high mortality and morbidity and is transmitted by direct and indirect contact. Patient isolation measures, i.e. single room isolation or cohorting, are usually recommended for infections that spread by contact.
Objectives: To determine the effect of patient isolation measures (single room isolation and/or cohorting) for infants with candida colonization or infection as an adjunct to routine infection control measures on the transmission of candida to other infants in the neonatal unit.
Search methods: Relevant trials in any language were searched in the following databases in July 2011: The Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, Issue 2, 2011), MEDLINE, BIOSIS, EMBASE and CINAHL. Proceedings of the Pediatric Academic Societies (from 1987) and ongoing trials were searched.
Selection criteria: Types of studies: Cluster randomized trials (where clusters may be defined by hospital, ward, or other subunits of the hospital).
Types of participants: Neonatal units caring for infants colonized or infected with Candida. Types of interventions: A policy of patient isolation measures (single room isolation or cohorting of infants with Candida colonization or infection) compared to routine isolation measures.
Data collection and analysis: The standard methods of the Cochrane Neonatal Review Group (CNRG) were used to identify studies and to assess the methodological quality of eligible cluster-randomized trials. Infection rates and colonization rates were to be expressed as rate ratios for each trial and if appropriate for meta-analysis, the generic inverse variance method in RevMan was to be used.
Main results: No eligible trials were identified.
Authors' conclusions: The review found no evidence to either support or refute the use of patient isolation measures (single room isolation or cohorting) in neonates with candida colonization or infection.Despite the evidence for transmission of candida by contact and evidence of cross-infection by health care workers, no standard policy of patient isolation measures beyond routine infection control measures exists in the neonatal unit. There is an urgent need to research the role of patient isolation measures for preventing transmission of candida in the neonatal unit. Well designed trials randomizing clusters of units or hospitals to a type of patient isolation method intervention are needed.
Conflict of interest statement
None
Update of
-
Patient isolation measures for infants with candida colonization or infection for preventing or reducing transmission of candida in neonatal units.Cochrane Database Syst Rev. 2007 Jul 18;(3):CD006068. doi: 10.1002/14651858.CD006068.pub2. Cochrane Database Syst Rev. 2007. Update in: Cochrane Database Syst Rev. 2011 Nov 09;(11):CD006068. doi: 10.1002/14651858.CD006068.pub3. PMID: 17636825 Updated.
References
References to studies excluded from this review
Ben‐Abraham 2002 {published data only}
-
- Ben‐Abraham R, Keller N, Szold O, Vardi A, Weinberg M, Barzilay Z, et al. Do isolation rooms reduce the rate of nosocomial infections in the pediatric intensive care unit?. Journal of Critical Care 2002;17:176‐80. - PubMed
Additional references
AAP 2002
-
- AAP, ACOG. Guidelines for Perinatal Care. Guidelines for Perinatal Care. Fifth. Washington DC: American Academy of Pediatrics, 2002:AAP, PO box 927, Elk grove Village, Illionois.
Adams‐Chapman 2002
-
- Adams‐Chapman I, Stoll BJ. Prevention of nosocomial infections in the neonatal intensive care unit. Current Opinion in Pediatrics 2002;14:157‐64. - PubMed
Baley 1984
-
- Baley JE, Kliegman RM, Fanaroff AA. Disseminated fungal infections in very low‐birth‐weight infants: therapeutic toxicity. Pediatrics 1984;73:153‐7. - PubMed
Baley 1986
-
- Baley JE, Kliegman RM, Boxerbaum B, Fanaroff AA. Fungal colonization in the very low birth weight infant. Pediatrics 1986;78:225‐32. - PubMed
Beck‐Sague 1993
-
- Beck‐Sague C, Jarvis WR. Secular trends in the epidemiology of nosocomial fungal infections in the United States, 1980‐1990. National Nosocomial Infections Surveillance System. Journal of Infectious Diseases 1993;167:1247‐51. - PubMed
Boyce 2002
-
- Boyce JM, Pittet D. Guidelines for hand hygiene in health‐care settings. MMWR 2002;51:1‐44. - PubMed
Burnie 1985
Campbell 1998
Cepeda 2005
-
- Cepeda JA, Whitehouse T, Cooper B, hails J, Jones K, Kwaku F, et al. Isolation of patients in single rooms or cohorts to reduce spread of MRSA in intensive care units: prospective two‐centre study. Lancet 2005;365:295‐304. - PubMed
Cooper 2004
Deeks 2004
-
- Deeks JJ, Higgins, JPT, Altman DG, editors. Cochrane Handbook for Systematic Reviews of Interventions 4.2.5 [updated May 2005]; Section 8: Analysing and presenting results. The Cochrane Library Cochrane. Chichester, U.K: John Wiley & Sons, Ltd, 2005, issue 1.
Dorko 2001
-
- Dorko E, Viragova S, Jautova J, Pilipcinec E, Danko J, Svicky E. Electrophoretic karyotyping of Candida albicans strains isolated from premature infants and hospital personnel in a neonatal intensive care unit. Folia Microbiologica (Praha) 2001;46:453‐7. - PubMed
Drummond 1991
-
- Drummond MF, Davies LM. Evaluation of the costs and benefits of reducing hospital infection. Journal of Hospital Infection 1991;18 Suppl A:85‐93. - PubMed
Drummond 1996
Edmond 1997
-
- Edmond MP. Isolation. Infection Control and Hospital Epidemiology 1997;18:58‐64. - PubMed
Fairchild 2002
-
- Fairchild KD, Tomkoria S, Sharp EC, Mena FV. Neonatal Candida glabrata sepsis. Clinical and laboratory features compared with other Candida species. Pediatric Infectious Disease Journal 2002;21:39‐43. - PubMed
Faix 1989
-
- Faix RG, Kovarik SM, Shaw TR. Mucocutaneous and invasive candidiasis among very low birthweight (less than 1,500 grams) infants in intensive care nurseries:a prospective study. Pediatrics 1989;83:101‐7. - PubMed
Faix 1992
-
- Faix RG. Invasive neonatal candidiasis: comparison of albicans and parapsilosis infection. Pediatric Infectious Disease Journal 1992;11:88‐93. - PubMed
Finkelstein 1993
-
- Finkelstein R, Reinhertz G, Hashman N, Merzbach D. Outbreak of Candida tropicalis fungemia in a neonatal intensive care unit. Infection Control and Hospital Epidemiology 1993;14:587‐90. - PubMed
Fowler 1998
-
- Fowler SL, Rhoton B, Springer SC, Messer SA, Hollis RJ, Pfaller MA. Evidence for person‐to‐person transmission of Candida lusitaniae in a neonatal intensive‐care unit. Infection Control and Hospital Epidemiology 1998;19:343‐5. - PubMed
Garner 1996a
-
- Garner JS. Guideline for isolation precautions in hospitals. Part I. Evolution of isolation practices, Hospital Infection Control Practices Advisory Committee. American Journal of Infection Control 1996;24:24‐31. - PubMed
Garner 1996b
-
- Garner JS. Guideline for isolation precautions in hospitals. The Hospital Infection Control Practices Advisory Committee. Infection Control and Hospital Epidemiology 1996;17:53‐80. - PubMed
Gastmeier 2004
-
- Gastmeier P, Schwab F, Geffers C, Ruden H. To isolate or not to isolate? Analysis of data from the German Nosocomial Infection Surveillance System regarding the placement of patients with methicillin‐resistant Staphylococcus aureus in private rooms in intensive care units. Infect Control Hosp Epidemiol 2004;25:109‐13. - PubMed
Goodacre 2005
Gudlaugsson 2003
-
- Gudlaugsson O, Gillespie S, Lee K, Vande Berg J, Hu J, Messer, et al. Attributable mortality of nosocomial candidemia, revised. Clinical Infectious Diseases 2003;37:1172‐7. - PubMed
Harris 2001
-
- Harris JS, Goldmann DA. Infections acquired in the nursery: Epidemiology and control. Remington JS, Klein JO, eds. Infectious Diseases of the Fetus and Newborn Infant. Philadelphia, London, Toronto, New York, St. Louis, Sydney: WB Saunders & Company, 2001:1371‐1418.
Horbar 2004
Huang 1998
-
- Huang YC, Li CC, Lin TY, Lien RI, Chou YH, Wu JL, et al. Association of fungal colonization and invasive disease in very low birth weight infants. Pediatric Infectious Disease Journal 1998;17:819‐22. - PubMed
Huang 1999
-
- Huang YC, Lin TY, Leu HS, Peng HL, Wu JH, Chang HY. Outbreak of Candida parapsilosis fungemia in neonatal intensive care units: clinical implications and genotyping analysis. Infection 1999;27:97‐102. - PubMed
Jarvis 1996
-
- Jarvis WR. The epidemiology of colonization. Infection Control and Hospital Epidemiology 1996;17:47‐52. - PubMed
Kaufman 2001
-
- Kaufman D, Boyle R, Hazen KC, Patrie JT, Robinson M, Donowitz LG. Fluconazole prophylaxis against fungal colonization and infection in preterm infants. New England Journal of Medicine 2001;345:1660‐6. - PubMed
Khatib 1998
-
- Khatib R, Thirumoorthi MC, Riederer KM, Sturm L, Oney LA, Baran J Jr. Clustering of Candida infections in the neonatal intensive care unit: concurrent emergence of multiple strains simulating intermittent outbreaks. Pediatric Infectious Disease Journal 1998;17:130‐4. - PubMed
Klein 1989
-
- Klein BS, Perloff WH, Maki DG. Reduction of nosocomial infection during pediatric intensive care by protective isolation. New England Journal of Medicine 1989;320:1714‐21. - PubMed
Kossoff 1998
-
- Kossoff EH, Buescher ES, Karlowicz MG. Candidemia in a neonatal intensive care unit: trends during fifteen years and clinical features of 111 cases. Pediatric Infectious Disease Journal 1998;17:504‐8. - PubMed
Larson 2005
-
- Larson EL, Cimiotti J, Haas J, Parides M, Nesin M, Della‐Latta P, Saiman L. Effect of antiseptic handwashing vs alcohol sanitizer on health‐care associated infections in neonatal intensive care units. Archives of Pediatric and Adolescent Medicine 2005;159:377‐83. - PubMed
Lupetti 2002
Makhoul 2001
-
- Makhoul IR, Kassis I, Smolkin T, Tamir A, Sujov P. Review of 49 neonates with acquired fungal sepsis: further characterization. Pediatrics 2001;107:61‐6. - PubMed
Miller 2001
-
- Miller LG, Hajjeh RA, Edwards JE Jr. Estimating the cost of nosocomial candidemia in the United States. Clinical Infectious Diseases 2001;32:1110. - PubMed
Morgan 2005
-
- Morgan J, Meltzer MI, Plikyatis BD, Sofair AN, Huie‐White S, Wilcox S, et al. Excess mortality, hospital stay and cost due to candidemia: a case‐control study using data from population‐based candidemia surveillance. Infection Control and Hospital Epidemiology 2005;26:540‐7. - PubMed
Murray 2004
Ng 2004
NNIS 2001
-
- Centers for Disease Control and Prevention. National Nosocomial Infections Surveillance (NNIS) System Report, Data Summary from January 1992‐June 2001, issued August 2001. American Journal of Infection Control 2001;29:404‐21. - PubMed
Olaechea 2004
-
- Olaechea PM, Palomar M, Leon‐Gil C, Alvarez‐Lerma F, Jorda R, Nolla‐Salas J, Leon‐Regidor MA, EPCAN study group. Economic impact of Candida colonization and Candida infection in the critically ill patient. European Journal of Clinical Microbiology and Infectious Diseases 2004;23:323‐30. - PubMed
Pfaller 1998a
-
- Pfaller MA, Jones RN, Messer SA, Edmond MB, Wenzel RP. National surveillance of nosocomial blood stream infection due to species of Candida other than Candida albicans: frequency of occurrence and antifungal susceptibility in the SCOPE Program. SCOPE Participant Group. Surveillance and Control of Pathogens of Epidemiologic. Diagnostic Microbiology and Infectious Disease 1998;30:121‐9. - PubMed
Pfaller 1998b
-
- Pfaller MA, Jones RN, Messer SA, Edmond MB, Wenzel RP. National surveillance of nosocomial blood stream infection due to Candida albicans: frequency of occurrence and antifungal susceptibility in the SCOPE Program. Diagnostic Microbiology and Infectious Disease 1998;31:327‐32. - PubMed
Puffer 2003
Rowen 2003
-
- Rowen JL. Mucocutaneous candidiasis. Seminars in Perinatology 2003;27:406‐13. - PubMed
Saiman 2000
-
- Saiman L, Ludington E, Pfaller M, Rangel‐Frausto S, Wiblin RT, Dawson J, et al. Risk factors for candidemia in Neonatal Intensive Care Unit patients. Pediatric Infectious Disease Journal 2000;19:319‐24. - PubMed
Saiman 2001
-
- Saiman L, Ludington E, Dawson JD, Patterson JE, Rangel‐Frausto S, Wiblin RT, et al. Risk factors for Candida species colonization of neonatal intensive care unit patients. Pediatric Infectious Disease Journal 2001;20:1119‐24. - PubMed
Saint 2001
-
- Saint S, Chenoweth C, Fendrick AM. The role of economic evaluation in infection control. American Journal of Infection Control 2001;29:338‐44. - PubMed
Schelonka 2006
-
- Schelonka RL, Scruggs S, Nichols K, Dimmit RA, Carlo WA. Sustained reductions in neonatal nosocomial infection rates following a comprehensive infection control intervention. Journal of Perinatology 2006;26:176‐9. - PubMed
Silverman 1999
-
- Silverman J, Vazquez JA, Sobel JD, Zervos MJ. Comparative in vitro activity of antiseptics and disinfectants versus clinical isolates of Candida species. Infection Control and Hospital Epidemiology 1999;20:676‐84. - PubMed
Stoll 2002
-
- Stoll BJ, Hansen N, Fanaroff AA, Wright LL, Carlo WA, Ehrenkranz RA, et al. Late‐onset sepsis in very low birth weight neonates: the experience of the NICHD Neonatal Research Network. Pediatrics 2002;110 (2 Pt 1):285‐91. - PubMed
Traore 2002
-
- Traore O, Springthorpe VS, Sattar SA. A quantitative study of the survival of two species of Candida on porous and non‐porous environmental surfaces and hands. Journal of Applied Microbiology 2002;92:549‐55. - PubMed
Waggoner‐Fountain 96
-
- Waggoner‐Fountain LA, Walker MW, Hollis RJ, Pfaller MA, Ferguson JE 2nd, Wenzel RP, et al. Vertical and horizontal transmission of unique Candida species to premature newborns. Clinical Infectious Diseases 1996;22:803‐8. - PubMed
References to other published versions of this review
Publication types
MeSH terms
LinkOut - more resources
Full Text Sources
Medical
Research Materials