Biermann C D, Kribs A, Roth B, Tantcheva-Poor I
Department of Neonatology and Paediatric Intensive Care, Childrens' Hospital, University of Cologne, Cologne, Germany.
Dermatology, University of Cologne, Cologne, Germany.
Klin Padiatr. 2016 Jul;228(4):208-12. doi: 10.1055/s-0042-104122. Epub 2016 Jun 30.
Background Nosocomial infections are a serious problem in the treatment of extremely low birth weight infants (ELBW, <1 000 g). In these patients, effective skin antisepsis is critical to prevent hospital-acquired infections and their sequelae. However, serious side effects of topical antiseptics have been repeatedly reported in extremely preterm infants and no agreement has been reached on the best product in this population. Therefore, we conducted a survey of the German NICUs aiming to investigate current practices and safety of topical antiseptics in ELBW neonates.
We sent anonymized questionnaires to 166 German NICUs with the highest level of care.
Usable questionnaires were returned by 64 NICUs (39%). These NICUs had treated a total of 2130 patients with a birth weight<1 000 g in 2012. Octenidine without phenoxyethanol (OwPh) and Octenisept(®) were the predominantly used skin antiseptics for intensive-care procedures. At least one skin complication was reported by 27% (n=17) of the NICUs. In 9 cases Octenisept(®) was used, and in 6 cases octenidine was used.
According to our knowledge, this is the first study surveying practices and safety of skin antisepsis in ELBWs in the German NICUs. Most German NICUs use octenidine, however, in different preparations. Skin complications including blistering, necrosis and scarring were seen with all octenidine products, a fact which has not been previously reported.
背景 医院感染是极低出生体重儿（ELBW，<1000克）治疗中的一个严重问题。对于这些患者，有效的皮肤消毒对于预防医院获得性感染及其后遗症至关重要。然而，局部消毒剂的严重副作用在极早产儿中屡有报道，对于该人群中最佳产品尚未达成共识。因此，我们对德国新生儿重症监护病房（NICU）进行了一项调查，旨在研究ELBW新生儿局部消毒剂的当前使用情况和安全性。
我们向166家德国最高护理水平的NICU发送了匿名问卷。
64家NICU（39%）返回了可用问卷。这些NICU在2012年共治疗了2130例出生体重<1000克的患者。不含苯氧乙醇的奥替尼啶（OwPh）和Octenisept（®）是重症监护程序中主要使用的皮肤消毒剂。27%（n=17）的NICU报告了至少一种皮肤并发症。其中9例使用了Octenisept（®），6例使用了奥替尼啶。
据我们所知，这是第一项调查德国NICU中ELBW皮肤消毒做法和安全性的研究。大多数德国NICU使用奥替尼啶，但制剂不同。所有奥替尼啶产品均出现了包括水疱、坏死和瘢痕形成在内的皮肤并发症，这一情况此前未见报道。
