The efficacy of very low-density sodium hypochloride washes in preventing healthcare-associated infections in pediatric intensive care units



Antibiotic resistance, Chlorhexidine gluconate, Gram negative bacteria, Healthcare-associated infections, Sodium hypochlorite


Aim: Healthcare-associated infections (HAIs) have increased in pediatric intensive care units (ICUs) within the last decade. Maintaining hand hygiene, performing invasive interventions in accordance with aseptic techniques, contact precautions and chlorhexidine gluconate showers are the usual prevention methods against HAIs. However, despite all prevention methods, HAI incidence has globally increased in pediatric ICUs. The purpose of this study is to investigate the preventive effects of 0.005% sodium hypochlorite (NaOCl) showers against HAIs in pediatric ICUs. 

Methods: This case control study was conducted in a 17-bed pediatric intensive care unit. Patients were washed with water and soap during the first six months and water and 0.005% sodium hypochlorite during the following six months, after which the incidence of HAIs was compared. The diagnosis of HAIs was made according to Centers for Disease Control and Prevention National Healthcare Safety Network guidelines.

Results: Two hundred thirty patients (118 patients in control group, 112 patients in NaOCl group) who met the inclusion criteria were included in the study. 26 patients among the control group and 20 patients among the NaOCl group were diagnosed with HAIs. In the NaOCl group, we detected 100% and 66% reductions in P. aeruginosa and S. aureus infections, respectively. There was no statistically significant difference between the groups in terms of overall HAI incidences (P=0.510). Most frequently encountered HAIs in both groups were ventilator-associated pneumonia and bloodstream infections. The rates of multidrug resistant gram-negative bacterial isolation were 77.8% (14/18) in the control group and 66.7% (5/15) in the sodium hypochlorite group. The rates of extensive drug resistant gram-negative bacterial isolation were 38.9% (7/18) in the control group and 26.7% (4/15) in the NaOCl group. There was no statistically significant difference between the two groups (P=0.458). We did not encounter any local or systemic side effects in any of our patients.

Conclusion: We found that weekly 0.005% NaOCl showers reduced P. aeruginosa and S. aureus infections, although it did not change length of hospital stay, incidence of total HAIs and the sensitivity of gram-negative bacteria to antibiotics.


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Çağan E, Kılıç N. The efficacy of very low-density sodium hypochloride washes in preventing healthcare-associated infections in pediatric intensive care units. J Surg Med [Internet]. 2019 Sep. 1 [cited 2024 May 25];3(9):648-51. Available from: