Central-line associated bloodstream infections in a tertiary care children’s University hospital: a prospective study

Venturini, Elisabetta; Montagnani, Carlotta; Benni, Alessandra; Becciani, Sabrina; Biermann, K.; Masi, Salvatore; Chiappini, Elena; Martino, Maurizio de; Galli, Luisa

doi:10.1186/s12879-016-2061-6

Cited by 30 publications

(19 citation statements)

References 20 publications

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“…The results from this prospective surveillance study in four heterogeneous PICU reflect the CLABSI incidence rate and risk factors in a major city in South America. The incidence of 3.9/1000 CVC-days found in this study is higher than the rates in North America (1.2 - 2.15); (3,4,7) rather, it is closer to European rates (1.7 - 3.7) (5,13) and is lower than the rates reported in developing countries according to the last International Nosocomial Infection Consortium. (6) In Sao Paulo, the health care assistance is considered to be the most advanced in Brazil, but improvements are needed to reach the healthcare-associated infection rates of the United States and Canada.…”

Section: Discussioncontrasting

confidence: 68%

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Risk factors for vascular catheter-related bloodstream infections in pediatric intensive care units

Torre¹,

Baldanzi²,

Troster³

2018

Revista Brasileira De Terapia Intensiva

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ObjectivesTo determine the risk factors for acquiring central line-associated blood stream infections (CLABSI) in pediatric intensive care units and to investigate the incidence and etiology of CLABSI in pediatric intensive care units with different profiles.MethodsThe study was a prospective cohort study in three hospitals. One of the hospitals is a large metropolitan public hospital with two pediatric intensive care units and a total of nineteen pediatric intensive care unit beds, another is a regional hospital with eight pediatric intensive care unit beds, and the third is a private hospital with fifteen beds. Patients between the ages of 1 month old and 18 years old who used a central venous catheter for over 24 hours were included. We recorded patients’ daily progress. General patient and catheter-related data were collected and used as variables. All the data were analyzed using Statistical Package for Social Science (SPSS), version 13.0, to compare patients with CLABSI with or without risk factors.ResultsA total of 728 patients were admitted to the pediatric intensive care units, and 170 had a central line in place for at least 24 hours. The median age was 32 months, and 97 (57%) of the patients were males. The CLABSI incidence rate was 3.9/1000 central venous catheter-days. The incidence among hospitals varied from 1.6 to 6.6. The overall mortality rate was 11.1%, and the CLABSI and non-CLABSI mortality rates were 12.9% and 10.7%, respectively. In multivariate analysis, independent risk factors for CLABSI were a longer duration of central venous catheter use (OR: 1.07; 95%CI 1.00 - 1.14; p = 0.019) and the use of more than one central venous catheter at once (OR: 2.59; 95%CI 1.17 - 5.73; p = 0.048).ConclusionA longer duration of central venous catheter use and the use of more than one central venous catheter at once were the main risk factors for CLABSI in pediatric intensive care units.

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Section: Discussioncontrasting

confidence: 68%

“…The most common pathogens isolated were gram-negative bacteria (72%), which is consistent with the results of previous studies. (5,22) Due to the risk of multiple antibiotic resistance, these microorganisms are of increasing concern. Among all the gram-negative isolates, 25% were resistant to carbapenem.…”

Section: Discussionmentioning

confidence: 99%

Risk factors for vascular catheter-related bloodstream infections in pediatric intensive care units

Torre¹,

Baldanzi²,

Troster³

2018

Revista Brasileira De Terapia Intensiva

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“…10 Although strong evidence indicates that most HA-BSIs are preventable, 9,[11][12][13][14][15][16] pediatric and neonatal HA-BSI rates remain far above zero in many countries worldwide, highlighting the need to initiate further national and targeted prevention strategies. [17][18][19] Published data regarding pediatric and neonatal HA-BSI outcomes vary significantly, depending on the country of origin, year of publication, and study design. 20 Accurate estimates of LOS, cost, and mortality attributed to HA-BSIs are essential for developing cost-effective infection prevention and infection control measures.…”

mentioning

confidence: 99%

Length of stay, cost, and mortality of healthcare-acquired bloodstream infections in children and neonates: A systematic review and meta-analysis

Karagiannidou

Triantafyllou

Zaoutis

et al. 2020

Infect. Control Hosp. Epidemiol.

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Objective:To estimate the attributable mortality, length of stay (LOS), and healthcare cost of pediatric and neonatal healthcare-acquired bloodstream infections (HA-BSIs).Design:A systematic review and meta-analysis.Methods:A systematic search (January 2000–September 2018) was conducted in PubMed, Cochrane, and CINAHL databases. Reference lists of selected articles were screened to identify additional studies. Case–control or cohort studies were eligible for inclusion when full text was available in English and data for at least 1 of the following criteria were provided: attributable or excess LOS, healthcare cost, or mortality rate due to HA-BSI. Study quality was evaluated using the Critical Appraisal Skills Programme Tool (CASP). Study selection and quality assessment were conducted by 2 independent researchers, and a third researcher was consulted to resolve any disagreements. Fixed- or random-effect models, as appropriate, were used to synthesize data. Heterogeneity and publication bias were evaluated.Results:In total, 21 studies were included in the systematic review and 13 studies were included in the meta-analysis. Attributable mean LOS ranged between 4 and 27.8 days; healthcare cost ranged between $1,642.16 and $160,804 (2019 USD) per patient with HA-BSI; and mortality rate ranged between 1.43% and 24%. The pooled mean attributable hospital LOS was 16.91 days (95% confidence interval [CI], 13.70–20.11) and the pooled attributable mortality rate was 8% (95% CI, 6–9). A meta-analysis was not conducted for cost due to lack of eligible studies.Conclusions:Pediatric HA-BSIs have a significant impact on mortality, LOS, and healthcare cost, further highlighting the need for implementation of HA-BSI prevention strategies.

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“…The completeness and accuracy of data are often two important issues for generating robust evidence for HAIs in the ICU. For instance, traditional HAI surveillance exclusively collects data of patients with HAIs, and such healthcare data, as diagnostic and treatment information, are usually unavailable 14–16. This limits the evaluation of interventional strategies for HAIs.…”

Section: Introductionmentioning

confidence: 99%

<p>Developing a Registry of Healthcare-Associated Infections at Intensive Care Units in West China: Study Rationale and Patient Characteristics</p>

Wang¹,

Zhu²,

He³

et al. 2019

CLEP

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PurposeLimited evidence is available to support the management of healthcare-associated infections (HAIs) in intensive care units (ICUs). Establishing a registry with complete and accurate information is urgently needed. The West China Hospital system has the most complete and largest data system for HAI in the ICU setting in China. By linking a multidimensional database, we developed a registry of HAI in ICU.MethodsThe ICU-HAI registry was established using a multi-source database that included electronic medical record (EMR), ICU system and ICU-HAI system in the West China Hospital healthcare system. Patients who were admitted to ICUs between 1 April 2015 and 30 March 2018 were included and data were extracted based on pre-designed, standardized data forms. We achieved the linkage of the three databases using a unique patient identification code, and cleaned the data based on standardized variable dictionaries and cleaning rules. We evaluated the quality of the registry through data verification and assessment of the quality of key variables.ResultsIn total, 23, 062 patients were included. The ICU mortality and hospital mortality were 5.4% and 5.5% respectively. A total of 855 patients developed ICU-HAIs, 1540 patients developed ventilator-associated events (VAE), and 171 patients developed possible ventilator-associated pneumonia (PVAP). Quality assessment showed that the accuracy of data extraction and linkage was 100%. Furthermore, 98% of all patients had at least one important laboratory tests performed, and the median number of tests performed was 4 to 5 per admission.ConclusionA unique registry for HAIs in the ICU setting was successfully established, which contains complete and accurate information for all patients in the ICU. The registry, linked from multiple data sources, provides unique research insights into the management of HAIs in the ICU setting in China.

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Central-line associated bloodstream infections in a tertiary care children’s University hospital: a prospective study

Cited by 30 publications

References 20 publications

Risk factors for vascular catheter-related bloodstream infections in pediatric intensive care units

Risk factors for vascular catheter-related bloodstream infections in pediatric intensive care units

Length of stay, cost, and mortality of healthcare-acquired bloodstream infections in children and neonates: A systematic review and meta-analysis

<p>Developing a Registry of Healthcare-Associated Infections at Intensive Care Units in West China: Study Rationale and Patient Characteristics</p>

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