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Meta-Analysis
. 2021 Jan 20;1(1):CD013326.
doi: 10.1002/14651858.CD013326.pub2.

Hand hygiene for the prevention of infections in neonates

Bankole Peter Kuti  1 , Tinuade A Ogunlesi  2 , Olabisi Oduwole  3 , Chukwudi Oringanje  4 , Ekong E Udoh  5 , Martin M Meremikwu  6
Affiliations
Meta-Analysis

Hand hygiene for the prevention of infections in neonates

Bankole Peter Kuti et al. Cochrane Database Syst Rev. .

Retraction in

Abstract

Background: Annually, infections contribute to approximately 25% of the 2.8 million neonatal deaths worldwide. Over 95% of sepsis-related neonatal deaths occur in low- and middle-income countries. Hand hygiene is an inexpensive and cost-effective method of preventing infection in neonates, making it an affordable and practicable intervention in low- and middle-income settings. Therefore, hand hygiene practices may hold strong prospects for reducing the occurrence of infection and infection-related neonatal death.

Objectives: To determine the effectiveness of different hand hygiene agents for preventing neonatal infection in community and health facility settings.

Search methods: We used the standard search strategy of Cochrane Neonatal to search the Cochrane Central Register of Controlled Trials (CENTRAL; 2019, Issue 5), in the Cochrane Library; MEDLINE via PubMed (1966 to 10 May 2019); Embase (1980 to 10 May 2019); and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) (1982 to 10 May 2019). We also searched clinical trials databases and the reference lists of retrieved articles for randomised controlled trials (RCTs) and quasi-randomised trials. Searches were updated 1 June 2020.

Selection criteria: We included RCTs, cross-over trials, and quasi-RCTs that included pregnant women, mothers, other caregivers, and healthcare workers who received interventions within the community or in health facility settings DATA COLLECTION AND ANALYSIS: We used standard methodological procedures expected by Cochrane and the GRADE approach to assess the certainty of evidence. Primary outcomes were incidence of (study author-defined) suspected infection within the first 28 days of life, bacteriologically confirmed infection within the first 28 days of life, all-cause mortality within the first seven days of life (early neonatal death), and all-cause mortality from the 8th to the 28th day of life (late neonatal death).

Main results: Our review included five studies: one RCT, one quasi-RCT, and three cross-over trials with a total of more than 5450 neonates (two studies included all neonates but did not report the actual number of neonates involved). Four studies involved 279 nurses working in neonatal intensive care units and all neonates on admission. The fifth study did not clearly state how many nurses were included in the study. Studies examined the effectiveness of different hand hygiene practices for the incidence of (study author-defined) suspected infection within the first 28 days of life. Two studies were rated as low risk for selection bias, another two were rated as high risk, and one study was rated as unclear risk. One study was rated as low risk for allocation bias, and four were rated as high risk. Only one of the five studies was rated as low risk for performance bias. 4% chlorhexidine gluconate (CHG) compared to plain liquid soap We are uncertain whether plain soap is better than 4% chlorhexidine gluconate (CHG) for nurses' skin based on very low-certainty evidence (mean difference (MD) -1.75, 95% confidence interval (CI) -3.31 to -0.19; 16 participants, 1 study; very low-certainty evidence). We identified no studies that reported on other outcomes for this comparison. 4% chlorhexidine gluconate compared to triclosan 1% One study compared 1% w/v triclosan with 4% chlorhexidine gluconate and suggests that 1% w/v triclosan may reduce the incidence of suspected infection (risk ratio (RR) 1.04, 95% CI 0.19 to 5.60; 1916 participants, 1 study; very low-certainty evidence). There may be fewer cases of infection in the 1% w/v triclosan group compared to the 4% chlorhexidine gluconate group (RR 6.01, 95% CI 3.56 to 10.14; 1916 participants, 1 study; very low-certainty evidence); however, we are uncertain of the available evidence. We identified no study that reported on all-cause mortality, duration of hospital stay, and adverse events for this comparison. 2% CHG compared to alcohol hand sanitiser (61% alcohol and emollients) We are uncertain whether 2% chlorhexidine gluconate reduces the risk of all infection in neonates compared to 61% alcohol hand sanitiser with regards to the incidence of all bacteriologically confirmed infection within the first 28 days of life (RR 2.19, 95% CI 1.79 to 2.69; 2932 participants, 1 study; very low-certainty evidence) in the 2% chlorhexidine gluconate group, but the evidence is very uncertain. The adverse outcome was reported as mean visual scoring on the skin. There may be little to no difference between the effects of 2% CHG on nurses' skin compared to alcohol hand sanitiser based on very low-certainty evidence (MD 0.80, 95% CI 0.01 to 1.59; 118 participants, 1 study; very low-certainty evidence). We identified no study that reported on all-cause mortality and other outcomes for this comparison. None of the included studies assessed all-cause mortality within the first seven days of life nor duration of hospital stay. AUTHORS' CONCLUSIONS: We are uncertain as to the superiority of one hand hygiene agent over another because this review included very few studies with very serious study limitations.

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Conflict of interest statement

BPK has no conflicts to declare. TAO has no conflicts to declare. OO has no conflicts to declare. CO has no conflicts to declare. EU has no conflicts to declare. MM has no conflicts to declare.

Figures

1
1
Study flow diagram.
2
2
Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
3
3
Risk of bias summary: review authors' judgements about each risk of bias item for each included study.
1.1
1.1. Analysis
Comparison 1: 2% chlorhexidine gluconate (CHG) versus alcohol hand sanitiser (61% alcohol and emollients), Outcome 1: Changes in the numbers of colony‐forming units (CFUs) on nurses’ hands
1.2
1.2. Analysis
Comparison 1: 2% chlorhexidine gluconate (CHG) versus alcohol hand sanitiser (61% alcohol and emollients), Outcome 2: Adverse events (higher score is better)
1.3
1.3. Analysis
Comparison 1: 2% chlorhexidine gluconate (CHG) versus alcohol hand sanitiser (61% alcohol and emollients), Outcome 3: Incidence rate of infection
2.1
2.1. Analysis
Comparison 2: 2% chlorhexidine gluconate (CHG) versus plain liquid soap, Outcome 1: Adverse outcome (higher score is better)
3.1
3.1. Analysis
Comparison 3: Chlorhexidine gluconate 4% versus triclosan 1%, Outcome 1: incidence of new infection
3.2
3.2. Analysis
Comparison 3: Chlorhexidine gluconate 4% versus triclosan 1%, Outcome 2: Adverse events (mean hand damage score)
4.1
4.1. Analysis
Comparison 4: Iodophor products (betadine vs Prepodyne), Outcome 1: Personnel hand colonisation
4.2
4.2. Analysis
Comparison 4: Iodophor products (betadine vs Prepodyne), Outcome 2: Infant umbilical positivity
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References

References to studies included in this review

Amortegui 1978 {published data only}
    1. Amortegui AJ, Buffenmeyer C. Comparison of the antiseptic effect of two Iodophor preparations on hand washing in a well-baby nursery. Journal of Obstetric, Gynecologic, and Neonatal Nursing 1978;7(6):35-8. [PMID: 252552 ] - PubMed
Larson 2000 {published data only}
    1. Larson E, Silberger M, Jakob K, Whittier S, Lai L, Latta PD, et al. Assessment of alternative hand hygiene regimens to improve skin health among neonatal intensive care unit nurses. Heart and Lung: Journal of Critical Care 2000;29(2):136-42. [PMID: ] - PubMed
Larson 2005 {published data only}
    1. Larson EL, Cimiotti J, Haas J, Parides M, Nesin M, Della-Latta P, et al. Effect of antiseptic handwashing vs alcohol sanitizer on health care-associated Infections in neonatal intensive care units. Archives of Pediatrics and Adolescent Medicine 2005;159(4):377-83. [PMID: 15809394 ] - PubMed
Sharma 2013 {published data only}
    1. Sharma VS, Dutta S, Taneja N, Narang A. Comparing hand hygiene measures in a neonatal ICU: a randomized crossover trial. Indian Pediatrics 2013;50(10):917-21. [PMID: 23585422 ] - PubMed
Webster 1991 {published data only}
    1. Webster J, Faoagali JL, Cartwright D. Elimination of methicillin-resistant Siaphylococcus aureus from a neonatal intensive care unit after hand washing with triclosan. Journal of Paediatric Child Health 1994;30:59-64. - PubMed
    1. Webster J. Handwashing in a neonatal intensive care nursery: product acceptability and effectiveness of chlorhexidine gluconate 4% and triclosan 1%. Journal of Hospital Infection 1992;21:137-41. - PubMed
    1. Webster J. Hand-washing in a neonatal Intensive care unit: comparative effectiveness of chlorhexidine gluconate 4% w/v and triclosan 1% w/v. Australian College of Midwives Incorporated Journal 1991;4(2):25-7. [PMID: ] - PubMed

References to studies excluded from this review

Asare 2009 {published data only}
    1. Asare A, Enweronu-Laryea CC, Newman MJ. Hand hygiene practices in a neonatal intensive care unit in Ghana. Journal of Infection in Developing Countries 2009;3(5):352-6. [PMID: ] - PubMed
Azor‐Martinez 2018 {published data only}
    1. Azor-Martinez E, Yui-Hifume R, Muñoz-Vico FJ, Jimenez-Noguera E, Strizzi JM, Martinez-Martinez I, et al. Effectiveness of a hand hygiene program at child care centers: a cluster randomized trial. Pediatrics 2018;142(5):e20181245. [PMID: 30297500 ] - PubMed
Ditai 2019 {published data only}
    1. Ditai J, Abeso J, Odeke NM, Mobbs N, Dusabe-Richards J, Mudoola M, et al. BabyGel pilot: a pilot cluster randomised trial of the provision of alcohol handgel to postpartum mothers to prevent neonatal and young infant infection-related morbidity in the community. Pilot and Feasibility Studies 2019;5(49):eCollection 2019. [DOI: 10.1186/s40814-019-0432-7] [PMID: 30962946 ] - PMC - PubMed
Janota 2014 {published data only}
    1. Janota J, Šebková S, Višňovská M, Kudláčková J, Hamplová D, Zach J. Hand hygiene with alcohol hand rub and gloves reduces the incidence of late onset sepsis in preterm neonates. Acta Paediatrica 2014;103(10):1053-6. [DOI: 10.1111/apa.12731] [PMID: ] - DOI - PubMed
Kaufman 2014 {published data only}
    1. Kaufman DA, Blackman A, Conaway MR, Sinkin RA. Nonsterile glove use in addition to hand hygiene to prevent late-onset infection in preterm infants: randomized clinical trial. JAMA Pediatrics 2014;168(10):909-16. [PMID: ] - PubMed
Ng 2004 {published data only}
    1. Ng PC, Wong HL, Lyon DJ, So KW, Liu F, Lam RK, et al. Combined use of alcohol hand rub and gloves reduces the incidence of late onset infection in very low birthweight infants. Archives of Disease in Childhood. Fetal and Neonatal Edition 2004;89:F336-40. [PMID: ] - PMC - PubMed
Webster 1989 {published data only}
    1. Webster J, Faoagali JL. An in-use comparison of chlorhexidine gluconate 4% w/v, glycol-poly-siloxane plus methylcellulose and a liquid soap in a special care baby unit. Journal of Hospital Infection 1989;14:141-51. - PubMed

References to ongoing studies

NCT03755635 {published data only}
    1. NCT03755635. Neonatal sepsis at neonatal intensive care units in Ghana. https://clinicalTrials.gov/show/NCT03755635. [DOI: ]

Additional references

Adams‐Chapman 2006
    1. Adams-Chapman I, Stoll BJ. Neonatal infection and long-term neurodevelopmental outcome in the preterm infant. Current Opinion in Infectious Diseases 2006;19(3):290-7. [DOI: 10.1097/01.qco.0000224825.57976.87] [PMID: ] - DOI - PubMed
Afonso 2017
    1. Afonso ED, Blot S. Effect of gestational age on the epidemiology of late-onset sepsis in neonatal intensive care units - a review. Expert Review of Anti-infective Therapy 2017;15(10):917-24. [DOI: 10.1080/14787210.2017.1379394] [PMID: ] - DOI - PubMed
Aiello 2003
    1. Aiello AE, Cimiotti J, Della-Latta P, Larson EL. A comparison of the bacteria found on the hands of ‘homemakers' and neonatal intensive care unit nurses. Journal of Hospital Infection 2003;54(4):310-5. [PMID: ] - PMC - PubMed
Ali 2001
    1. Ali Y, Dolan MJ, Fendler EJ, Larson EL. Alcohols. In: Block SS, editors(s). Disinfection, Sterilization, and Preservation. 5th edition. Philadelphia (PA): Lippincott Williams & Wilkins, 2001:229-54.
Bello 2020
    1. Bello S, Bamgboye EA, Ajayi DT, Ossai EN, Aniwada EC, Salawu MM, et al. Handwash versus hand-rub practices for preventing nosocomial infection in hospital intensive care units: a systematic review and meta-analysis. Canadian Journal of Infection Control 2020;35(2):82-90.
Bigliardi 2017
    1. Bigliardi PL, Alsagoff SA, El-Kafrawi HY, Pyon JK, Wa CT, Villa MA. Povidone iodine in wound healing: a review of current concepts and practices. International Journal of Surgery 2017;1(44):260-8. - PubMed
CADTH 2014
    1. Canadian Agency for Drugs and Technologies in Health. Alcohol with chlorhexidine hand sanitizers: clinical effectiveness and guidelines. https://cadth.ca/alcohol-chlorhexidine-hand-sanitizers-clinical-effectiv... (accessed 19 March 2019).
Chan 2013
    1. Chan GJ, Lee AC, Baqui AH, Tan J, Black RE. Risk of early-onset neonatal infection with maternal infection or colonization: a global systematic review and meta-analysis. PLoS Medicine 2013;10(8):e1001502. [DOI: 10.1371/journal.pmed.1001502] [PMID: ] - DOI - PMC - PubMed
Chu 2014
    1. Chu SM, Hsu JF, Lee CW, Lien R, Huang HR, Chiang MC, et al. Neurological complications after neonatal bacteremia: the clinical characteristics, risk factors, and outcomes. PLOS One 2014;9(11):e105294. [DOI: 10.1371/journal.pone.0105294] [PMID: ] - DOI - PMC - PubMed
Cortese 2016
    1. Cortese F, Scicchitano P, Gesualdo M, Filaninno A, De Giorgi E, Schettini F, et al. Early and late infections in newborns: where do we stand? A review. Pediatrics and Neonatology 2016;57(4):265-73. [DOI: 10.1016/j.pedneo.2015.09.007] [PMID: ] - DOI - PubMed
Deeks 2011
    1. Deeks JJ, Higgins JPT, Altman DG, on behalf of the Cochrane Statistical Methods Group, editor(s). Analysing data and undertaking meta-analysis. In: Higgins JPT, Green S editor(s), editors(s). Cochrane Handbook for Systematic Reviews of Interventions, Chapter 9. Version 5.1.0 edition. Available from cochrane-handbook.org: Cochrane, 2011, updated March 2011.
Effa 2017
    1. Effa E, Durao S, Kredo T, Mbuagbaw L, Meremikwu M, Ongolo-Zogo P, et al. Process and lessons learned during priority setting in three countries in Africa. In: Abstracts of the Global Evidence Summit. Vol. 9 Suppl 1. Cape Town, South Africa: Cochrane Database of Systematic Reviews, 2017:107. [DOI: ]
Gebremedhin 2016
    1. Gebremedhin D, Berhe H, Gebrekirstos K. Risk factors for neonatal sepsis in public hospitals of Mekelle City, North Ethiopia, 2015: unmatched case control study. PLOS One 2016;11(5):e0154798. [DOI: 10.1371/journal.pone.0154798] [PMID: ] - DOI - PMC - PubMed
Goldstein 2005
    1. Goldstein B, Giroir B, Randolph A, International Consensus Conference on Pediatric Sepsis. International pediatric sepsis consensus conference: definitions for sepsis and organ dysfunction in pediatrics. Pediatric Critical Care Medicine 2005;6(1):2-8. [DOI: 10.1097/01.PCC.0000149131.72248.E6] [PMID: ] - DOI - PubMed
Gottardi 2001
    1. Gottardi W. Iodine and iodine compounds. In: Block SS, editors(s). Disinfection, sterilization, and preservation. 5th edition. Vol. 4. Gainesville, FL: Lippincott Williams & Wilkins, 2001:159-83.
GRADEpro GDT [Computer program]
    1. McMaster University (developed by Evidence Prime) GRADEpro GDT. Version accessed 2 April 2018. Hamilton (ON): McMaster University (developed by Evidence Prime), 2015. Available at gradepro.org.
Greenland 2013
    1. Greenland K, Iradati E, Ati A, Maskoen YY, Aunger R. The context and practice of handwashing among new mothers in Serang, Indonesia: a formative research study. BMC Public Health 2013;13:830. [DOI: 10.1186/1471-2458-13-830] [PMID: ] - DOI - PMC - PubMed
Haque 2007
    1. Haque KN. Defining common infections in children and neonates. Journal of Hospital Infection 2007;65(Suppl 2):110-4. [DOI: 10.1016/S0195-6701(07)60026-7] [PMID: ] - DOI - PubMed
Herruzo‐Cabrera 2001
    1. Herruzo-Cabrera R, Garcia-Caballero J, Martin-Moreno J, Graciani-Perez-Regadera MA, Perez-Rodriguez J. Clinical assay of N-duopropenide alcohol solution on hand application in newborn and pediatric intensive care units: control of an outbreak of multiresistant Klebsiella pneumoniae in a newborn intensive care unit with this measure. American Journal of Infection Control 2001;29(3):162-7. [DOI: 10.1067/mic.2001.115582] [PMID: ] - DOI - PubMed
Higgins 2011
    1. Higgins JP, Green S, editor(s). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 (updated March 2011). The Cochrane Collaboration, 2011. Available from handbook.cochrane.org.
Larson 1998
    1. Larson EL, Hughes CA, Pyrek JD, Sparks SM, Cagatay EU, Bartkus JM. Changes in bacterial flora associated with skin damage on hands of health care personnel. American Journal of Infection Control 1998;26(5):513-21. [PMID: ] - PubMed
Liu 2015
    1. Liu L, Oza S, Hogan D, Perin J, Rudan I, Lawn JE, et al. Global, regional, and national causes of child mortality in 2000–13, with projections to inform post-2015 priorities: an updated systematic analysis. Lancet 2015;385(9966):430-40; Erratum in: Lancet; 2015; 31;385(9966):420. [DOI: 10.1016/S0140-6736(14)61698-6] [PMID: ] - DOI - PubMed
Loveday 2014
    1. Loveday HP, Wilson JA, Pratt RJ, Golsorki M, Tingle A, Bak A, et al. epic3: national evidence-based guidelines for preventing healthcare-associated infections in NHS hospitals in England. Journal of Hospital Infection 2014;86 Suppl(1):S1-70. [DOI: 10.1016/S0195-6701(13)60012-2] [PMID: ] - DOI - PMC - PubMed
Moher 2009
    1. Moher D, Liberati A, Tetzlaff J, Altman DG, PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Journal of Clinical Epidemiology 2009;62(10):1006-12. [PMID: ] - PubMed
Mortimer 1962
    1. Mortimer EA Jr, Lipsitz PJ, Wolinsky E, Gonzaga AJ, Rammelkamp CH Jr. Transmission of staphylococci between newborns. Importance of the hands to personnel. American Journal of Diseases of Children (1960) 1962;104:289-95. [PMID: ] - PubMed
Pessoa‐Silva 2004
    1. Pessoa-Silva CL, Dharan S, Hugonnet S, Touveneau S, Posfay-Barbe K, Pfister R, et al. Dynamics of bacterial hand contamination during routine neonatal care. Infection Control and Hospital Epidemiology 2004;25(3):192-7. [10.1086/502376] [PMID: ] - PubMed
Ram 2017
    1. Ram PK, Nasreen S, Kamm K, Allen J, Kumar S, Rahman MA, et al. Impact of an intensive perinatal handwashing promotion intervention on maternal handwashing behavior in the neonatal period: findings from a randomized controlled trial in rural Bangladesh. BioMed Research International 2017;2017:6081470. [DOI: 10.1155/2017/6081470] [PMID: ] - DOI - PMC - PubMed
Ranjeva 2018
    1. Ranjeva SL, Warf BC, Schiff SJ. Economic burden of neonatal sepsis in sub-Saharan Africa. BMJ Global Health 2018;3(1):e000347. [DOI: 10.1136/bmjgh-2017-000347] [PMID: ] - DOI - PMC - PubMed
Review Manager 2014 [Computer program]
    1. Nordic Cochrane Centre, The Cochrane Collaboration Review Manager 5 (RevMan 5). Version 5.3. Copenhagen: Nordic Cochrane Centre, The Cochrane Collaboration, 2014.
Rhee 2008
    1. Rhee V, Mullany LC, Khatry SK, Katz J, LeClerq SC, Darmstadt GL, et al. Maternal and birth attendant hand washing and neonatal mortality in southern Nepal. Archives of Pediatrics & Adolescent Medicine 2008;162(7):603-8. [DOI: 10.1001/archpedi.162.7.603] [PMID: ] - DOI - PMC - PubMed
Rotter 1999
    1. Rotter M. Hand washing and hand disinfection. In: Mayhall CG, editors(s). Hospital Epidemiology and Infection Control. 2nd edition. Philadelphia (PA): Lippincott Williams & Wilkins, 1999:1339-55.
Schuchat 2000
    1. Schuchat A, Zywicki SS, Dinsmoor MJ, Mercer B, Romaguera J, O'Sullivan MJ, et al. Risk factors and opportunities for prevention of early-onset neonatal sepsis: a multicenter case-control study. Pediatrics 2000;105(1 Pt 1):21-6. [PMID: ] - PubMed
Schünemann 2013
    1. Schünemann H, Brożek J, Guyatt G, Oxman A, editor(s). Handbook for Grading the Quality of Evidence and the Strength of Recommendations Using the GRADE Approach (updated October 2013). GRADE Working Group, 2013. Available from gdt.guidelinedevelopment.org/app/handbook/handbook.html.
Tanner 2016
    1. Tanner J, Dumville JC, Norman G, Fortnam M. Surgical hand antisepsis to reduce surgical site infection. Cochrane Database of Systematic Reviews 2016, Issue 1. Art. No: CD004288. [DOI: 10.1002/14651858.CD004288.pub3] - DOI - PMC - PubMed
UN 2017
    1. United Nations Economic and Social Council. Progress towards the sustainable development goals: report of the Secretary-General. 2017. https://unstats.un.org/sdgs/files/report/2017/secretary-general-sdg-repo... (accessed 28 June 2018).
Webster 1994
    1. Webster J, Faoagali JL, Cartwright D. Elimination of methicillin-resistant Staphylococcus aureus from a neonatal intensive care unit after hand washing with triclosan. Journal of Paediatrics and Child Health 1994;30(1):59-64. [PMID: ] - PubMed
WHO 2009
    1. World Health Organization. WHO guidelines on hand hygiene in health care: a summary. http://apps.who.int/iris/bitstream/10665/70126/1/WHO_IER_PSP_2009.07_eng... (accessed 2 April 2018).
Won 2004
    1. Won SP, Chou HC, Hsieh WS, Chen CY, Huang SM, Tsou KI, et al. Handwashing program for the prevention of nosocomial infections in a neonatal intensive care unit. Infection Control and Hospital Epidemiology 2004;25(9):742-6. [DOI: 10.1086/502470] [PMID: ] - DOI - PubMed
Wynn 2010
    1. Wynn JL, Levy O. Role of innate host defences in susceptibility to early-onset neonatal sepsis. Clinics in Perinatology 2010;37(2):307-37. [DOI: 10.1016/j.clp.2010.04.001] [PMID: ] - PMC - PubMed
Zafar 1995
    1. Zafar AB, Butler RC, Reese DJ, Gaydos LA, Mennonna PA. Use of 0.3% triclosan (Bacti–Stat) to eradicate an outbreak of methicillin-resistant Staphylococcus aureus in a neonatal nursery. American Journal of Infection Control 1995;23(3):200-8. [PMID: ] - PubMed

References to other published versions of this review

Kuti 2019
    1. Kuti BP, Ogunlesi TA, Oduwole O, Oringanje C, Udoh EE, Meremikwu MM. Hand hygiene for the prevention of infections in neonates. Cochrane Database of Systematic Reviews 2019, Issue 5. Art. No: CD013326. [DOI: 10.1002/14651858.CD013326] - DOI - PubMed

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