Benefits of universal gloving on hospital-acquired infections in acute care pediatric units.

Yin, Jun; Schweizer, Marin L; Herwaldt, Loreen A; Pottinger, Jean M; Perencevich, Eli N

BACKGROUND To prevent transmission, some pediatric units require clinicians to wear gloves for all patient contacts during RSV season. We sought to assess whether a mandatory gloving policy reduced the risk of other health care-acquired infections (HAIs). METHODS This retrospective cohort study included all patients admitted to pediatric units of a tertiary care center between 2002 and 2010. Poisson regression models were used to measure the association between mandatory gloving and HAI incidence. Autoregressive models were used to adjust for time correlation. RESULTS During the study period, 686 HAIs occurred during 363 782 patient-days. The risk of any HAI was 25% lower during mandatory gloving periods compared with during nongloving periods (relative risk [RR]: 0.75; 95% confidence interval [CI]: 0.69-0.93; P = .01), after adjusting for long-term trends and seasonal effect. Mandatory gloving was associated with lower risks of bloodstream infections (RR: 0.63; 95% CI: 0.49-0.81; P < .001), central line-associated bloodstream infections (RR: 0.61; 95% CI: 0.44-0.84; P = 0.003), and hospital-acquired pneumonia (RR: 0.20; 95% CI: 0.03-1.25; P= 0.09). The reduction was significant in the PICU (RR: 0.63; 95% CI: 0.42-0.93; P = .02), the NICU (RR: 0.62; 95% CI: 0.39-0.98; P = .04), and the Pediatric Bone Marrow Transplant Unit (RR: 0.52; 95% CI: 0.29-0.91, P = .02). CONCLUSIONS Universal gloving during RSV season was associated with significantly lower rates of bacteremia and central line-associated bloodstream infections, particularly in the ICUs and the Pediatric Bone Marrow Transplant Unit.