Bacterial colonisation of previously prepared neonatal endotracheal tubes in the delivery room

Neonatal resuscitation equipment: A hidden risk for our babies?

“…As all samples from control items and those which were freshly cleaned exhibited no growth, there were no concerns about either batch contamination or accepting zero growth as the gold standard to aim for. Coagulase negative staphylococcus was the most prevalent organism, similar to in a previous surveillance study . Reflecting likely contamination from skin flora, it can cause life‐threatening sepsis in neonates, in particular as a cause of late‐onset sepsis in those born very premature or with low birth weight .…”

“…High levels of bacterial contamination were previously demonstrated on pre-opened endotracheal tubes, 9 and we found bacterial contamination on 44% of pre-prepared or exposed equipment ( Table 2). As all samples from control items and those which were freshly cleaned exhibited no growth, there were no concerns about either batch contamination or accepting zero growth as the gold standard to aim for.…”

“…Additionally most neonatal resuscitations occur on the labour ward, but this area has been largely neglected in surveillance studies. One small study determined the prevalence of contamination on endotracheal tubes in the delivery suite as 79% but there are no published studies looking at other commonly used neonatal pieces such as facemasks or laryngoscope blades. This area, therefore, may represent a significant source of bacteria and potential HAIs.…”

Clinical Issues—June 2012

“…In a study that investigated the contamination rates of 19 prepared neonatal ETTs randomly collected and cultured from resuscitation carts located in delivery rooms on four different days during a three‐week period, researchers found that bacteria were present on 15 of the 19 tubes cultured. Coagulase‐negative staphylococci was the most frequently identified organism 4 . Although of little significance in healthy adult patients, infection with coagulase‐negative staphylococci can result in serious morbidity and mortality in the neonatal patient 5,6 .…”

Does pre‐preparing endotracheal tubes increase the risk of contamination with potentially pathogenic bacteria?

“…The study conducted by Walsh et al 2 presented the most relevant evidence of the four studies, although not of the highest level (1c), as it was the only one to investigate neonatal ETTs and the delivery room environment. The other studies 1,3,4 involved adult equipment, larger tubes and different environments.…”