38 Section I ■ Preparation and Support

4. Iodophor (5,12,13)

a. Burns possible when allowed to pool under infant

b. Absorption through skin reported in burn patients

and neonates

c. Alteration of thyroid function

5. Chlorhexidine

a. Similarity in name and preparation has led to some

confusion between chlorhexidine and hexachlorophene. These compounds are different in structure

and properties (Table 5.1).

b. Sensorineural deafness when instilled into middle

ear; ocular toxicity with direct exposure to eye (20)

c. Burns possible when allowed to pool under infant

d. Absorption through skin and from umbilical stump

(21). No associated pathology was documented.

e. Contamination with gram-negative organisms has

been reported, in particular Pseudomonas and

Proteus species (22).

f. There is no evidence that the detergent or alcohol

preparations are susceptible to contamination.

6. Alcohol

a. Burns in premature infants (23)

b. Exposure to high concentrations of alcohol vapors

in incubators (11)

7. Latex

a. Allergy in operators

b. Allergy in infants with neural tube defects (16)

References

1. Centers for Disease Control and Prevention. Guidelines for environmental infection control in health-care facilities. MMWR

Recomm Rep. 2003;52(10):1.

2. Centers for Disease Control and Prevention [Internet]. 2011

Guidelines for the prevention of intravascular catheter-related

infections. http://www.cdc.gov/hicpac/BSI/BSI-guidelines-2011.

html. Accessed April 24, 2012.

3. Kilbride HW, Powers R, Wirtschafter DD, et al. Evaluation and

development of potentially better practices to prevent neonatal

nosocomial bacteremia. Pediatrics. 2003;111:504.

4. Pittet D. Improving adherence to hand hygiene practice: a multidisciplinary approach. Emerg Infect Dis. 2001;7:234.

5. Linder N, Davidovitch N, Reichman B, et al. Topical iodine-containing antiseptics and subclinical hypothyroidism in preterm

infants. J Pediatr. 1997;131(3):434.

6. Siegel JD, Rhinehart E, Jackson M, et al; the Healthcare Infection

Control Practices Advisory Committee 2007 Guideline for isolation precautions: preventing transmission of infectious agents in

healthcare aettings. http://www.cdc.gov/hicpac/2007IP/2007isolat

ionPrecautions.html. Accessed April 24, 2012.

7. Centers for Disease Control and Prevention. Recommendations

for preventing transmission of human immunodeficiency virus

and hepatitis B virus to patients during exposure-prone invasive

procedures. MMWR Recomm Rep. 1991;40(8):1.

8. Boyce JM, Pittet D. Guideline for Hand Hygiene in Health-Care

Settings: recommendations of the Healthcare Infection Control

Practices Advisory Committee and the HICPAC/SHEA/APIC/

IDSA Hand Hygiene Task Force. Infect Control Hosp Epidemiol.

2002;23(S12):S3.

9. Garland JS, Alex CP, Uhing MR, et al. Pilot trial to compare tolerance of chlorhexidine gluconate to povidone-iodine antisepsis

for central venous catheter placement in neonates. J Perinatol.

2009;29(12):808. Epub 2009 Oct 8.

10. Intravenous Nurses Society. Intravenous nursing standards of

practice. J Intraven Nurs. 1998;21:51.

11. Paccaud C, Vernez M, Berode N, et al. Hand-disinfectant alcoholic

vapors in incubators. J Neonatal Perinatal Med. 2011;4(1):15.

12. Brown RS, Bloomfield S, Bednarek FJ, et al. Routine skin cleansing with povidone–iodine is not a common cause of transient neonatal hypothyroidism in North America: a prospective controlled

study. Thyroid. 1997;7:395.

13. Kovacikova L, Kunovsky P, Lakomy M, et al. Thyroid function

and ioduria in infants after cardiac surgery: comparison of patients

with primary and delayed sternal closure. Pediatr Crit Care Med.

2005;6(2):154.

14. Wilkinson AR, Baum JD, Keeling JW. Letter to the editor: superficial skin necrosis in babies prepared for umbilical arterial catheterization. Arch Dis Child. 1981;56:237.

15. American Academy of Pediatrics, American College of Obstetricians

and Gynecologists. Guidelines for Perinatal Care. 5th ed. Elk Grove

Village, IL: American Academy of Pediatrics; Washington, DC:

American College of Obstetricians and Gynecologists; 2002.

16. Majed M, Negat F, Khashab ME, et al. Risk factors for latex sensitization in young children with myelomeningocele. J Neurosurg

Pediatr. 2009;4(30):285.

17. Sehulster L, Chinn RYW. Guidelines for Environmental Infection

Control in Health-Care Facilities. Recommendations of CDC and

the Healthcare Infection Control Practices Advisory Committee

(HICPAC). MMWR Recomm Rep. 2003;52(RR10:1.

18. Check W. New study shows hexachlorophene is teratogenic in

humans. JAMA. 1978;240:513.

19. Lee SK, Zhai H, Maibach HI. Allergic contact dermatitis from

iodine preparations: a conundrum. Contact Dermatitis.

2005;52:184.

20. Brickwell PG. Sensorineural deafness following myringoplasty

operations. J Laryngol Otol. 1971;85:957.

21. Agett PJ, Cooper LV, Ellis SH, et al. Percutaneous absorption of

chlorhexidine in neonatal cord care. Arch Dis Child. 1981;56:878.

22. Wishart MM, Riley TV. Infection with Pseudomonas maltophilia.

Hospital outbreak due to contaminated disinfectant. Med J Aust.

1976;2:710.