Improved compliance with handwashing was associated with a significant decrease in overall rates of nosocomial infection and respiratory infections in particular. Washing hands is a simple, economical, and effective method for preventing nosocomial infections in the NICU.

No abstract

The variation rate within the coding region of UDPglucuronosyl transferase 1A1 (UGT1A1) gene in Taiwan Chinese was found to be 29.3%. This study sought to determine whether that high variation rate of UGT1A1 gene is a risk factor for neonatal hyperbilirubinemia. The study subjects consisted of 123 newborn infants suffering from unconjugated hyperbilirubinemia who had no known risk factors for hyperbilirubinemia and 218 healthy control neonates. The promoter area, exons 1 to 4, coding region of exon 5, and the flanking intronic regions in UGT1A1 gene were determined by the PCR in all subjects. Wild UGT1A1 gene, variation in the promoter, variation at nucleotide 211, variation at nucleotide 1091, and compound heterozygous variation of UGT1A1 gene were found. The percentage of neonates with wild UGT1A1 gene and the percentage of neonates with variation at nucleotide 211 were significantly different between the study subjects and controls. The percentages with bilirubin м342 M (20.0 mg/dL) and with persistent hyperbilirubinemia in the subjects carrying homozygous variation at nucleotide 211 (Gly71Arg) were significantly higher than the neonates carrying wild type or other genotypes. In conclusion, this study has demonstrated that variation at nucleotide 211 of the UGT1A1 gene is a risk factor for the development of neonatal hyperbilirubinemia. Pediatricians should closely follow hyperbilirubinemic newborn infants who carry homozygous 211 G to A variation in UGT1A1 gene. UDP-glucuronosyl transferase 1A1 (UGT1A1) is the key enzyme for bilirubin conjugation. Defects in this enzyme can cause a nonhemolytic unconjugated hyperbilirubinemia such as Crigler-Najjar syndrome type 1 (CN 1), type 2 (CN 2) and Gilbert's syndrome. Because UGT1A1 is too labile to be measured by classic biochemical methods, nonhemolytic unconjugated hyperbilirubinemia is ideally studied at the genetic level (1). The cDNA of human UGT1A1 gene was found to be located at chromosome 2q37 and was cloned in 1991 (1). This led to the detection of genetic defects in patients with CN 1 (2), CN 2 (3), and Gilbert's syndrome (4). CN 1 and Gilbert's syndrome have been shown to be mainly associated with mutations in exons 2 to 5 and promoter area, respectively (5).CN 2 and Gilbert's syndrome may be inherited as a recessive trait or as a dominant trait (4, 6, 7).The peak serum levels of unconjugated bilirubin in full-term Asian (Japanese, Korean, or Chinese) and American Indian neonates are double those in Caucasian and black populations (8). The incidence of kernicterus is also higher among Asian newborn infants (9). These findings suggest that genetic factors are involved in the development of neonatal hyperbilirubinemia. Recently, homozygous A(TA) 7 TAA variation in promoter of UGT1A1 gene was found to be associated with neonatal hyperbilirubinemia in Sephardic Jews (10), Americans (11), Italians (12,13), and British (14). However, in Japanese studies, the high allele-frequency of Gly71Arg in UGT1A1 gene was found to be responsible for neonatal hyperbilirubin...

Differences existed in the mental and motor development among Taiwanese and American infants. Our preliminary norms of the BSID-II may be more appropriate than the United States norms for Taiwanese children.