From the Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom.
Vaccines and Immunity theme, Medical Research Council Unit, The Gambia at London School of Hygiene and Tropical Medicine, London, United Kingdom.
Pediatr Infect Dis J. 2021 May 1;40(5S):S1-S4. doi: 10.1097/INF.0000000000002927.
Globally, about 3-quarters of births now occur in healthcare facilities, with the proportion being 50% for sub-Saharan Africa, where healthcare-associated infections among newborns are typically 3-20 times higher than in facilities in high-income countries. As this upward trend in institutional deliveries continues, the demand for specialized neonatal care also rises, with dedicated units often only available in tertiary referral hospitals in the case of low- and middle-income countries. Preventing nosocomial infections among vulnerable newborns requires effective and feasible control strategies and interventions. The role of cleaning and cleaners in reducing risks and maintaining a clean safe environment has until very recently been neglected at policy, program, practice, and research levels. There is now an opportunity to reposition cleaning within global and national initiatives related to Water, Sanitation and Hygiene, Infection Prevention and Control, and Antimicrobial Resistance. The evidence base should also be strengthened on cost-effective bundles of cleaning interventions, particularly in the context of low-resource settings. Here increasing overcrowding and shortages of staff and supplies present major threats to neonatal survival and well-being and heighten the case for optimizing the use of low-cost, back-to-basics interventions like cleaning.
在全球范围内，现在大约有四分之三的分娩发生在医疗机构中，其中撒哈拉以南非洲地区的这一比例为 50%，在该地区，新生儿的医护相关感染率通常比高收入国家的医疗机构高 3-20 倍。随着医疗机构分娩的这种上升趋势持续下去，对专门新生儿护理的需求也在增加，在中低收入国家，专门的新生儿病房通常只在三级转诊医院才有。为了防止脆弱的新生儿发生医院感染，需要采取有效且可行的控制策略和干预措施。直到最近，在政策、规划、实践和研究层面，清洁和清洁人员在降低风险和保持清洁安全环境方面的作用一直被忽视。现在有机会在与水、环境卫生和个人卫生、感染预防和控制以及抗微生物药物耐药性相关的全球和国家倡议中重新定位清洁工作。还应加强关于具有成本效益的清洁干预措施的证据基础，特别是在资源匮乏的环境中。在这种情况下，过度拥挤以及人员和物资短缺对新生儿的生存和健康构成了重大威胁，因此有必要优化使用清洁等低成本、基本干预措施。
