Metrics details. In neonatal intensive care units NICUs , neonates requiring medical care after birth, including very vulnerable preterm infants, are housed in incubators. Previous studies have reported that the standard chemical disinfection measures used to disinfect these incubators are insufficient to eradicate contaminating bacteria, leading to a worrying infectious risk for preterm neonates.
This study aimed to evaluate the efficacy of a disinfection method based on steam pulverization to eradicate the persistent bacterial contamination in such incubators. In a tertiary NICU, 20 incubators were monitored qualitatively for bacterial contamination at five different sites the rubber grommet, the left door handles, the temperature adjustment button, the mattress and the scale using a culture method at three times: before and after steam pulverization then 24 h after turning on and housing a new neonate.
Clinical data of neonates housed in each incubator were retrieved from the medical records to identify potential occurrence of late onset sepsis LOS. Just after steam pulverization, only two incubators were free from bacteria. Three preterm neonates developed LOS after being housed in a disinfected incubator but the bacterial species involved have not been identified in their incubator after disinfection. In two cases, the bacterium had been isolated from the mattress 24 h after housing the infected patient.
Steam pulverization is not sufficient to eradicate bacterial contamination of incubators. These results highlight the urgent need for an effective disinfection method, especially for mattresses that are in constant contact with patients.
In parallel, new incubator designs and mattress protections must be developed. In neonatal intensive care units NICUs , late onset sepsis LOS are frequent and responsible for increased morbidity and mortality, especially among very low birth weight preterm infants [ 1 ]. In NICUs, preterm neonates are in close contact with their environment including their hosting incubator and the medical equipment but also with their parents and caregivers, which are all potential bacterial reservoirs.
