Closed Catheter Access System Implementation in Reducing the Bloodstream Infection Rate in Low Birth Weight Preterm Infants

Abstract

Background: Bloodstream infection (BSI) is one of the significant causes of morbidity and mortality encountered in a neonatal intensive care unit, especially in developing countries. Despite the implementation of infection control practices, such as strict hand hygiene, the BSI rate in our hospital is still high. The use of a closed catheter access system to reduce BSI related to intravascular catheter has hitherto never been evaluated in our hospital.Objective: To determine the effects of closed catheter access system implementation in reducing the BSI rate in preterm neonates with low birth weight.Methods: Randomized clinical trial was conducted on 60 low birth weight preterm infants hospitalized in the neonatal unit at Cipto Mangunkusumo Hospital, Jakarta, Indonesia from June to September 2013. Randomized subjects either received a closed or non-closed catheter access system. Subjects were monitored for 2 weeks for the development of BSI based on clinical signs, abnormal infection parameters, and blood culture.Results: Closed catheter access system implementation gave a protective effect toward the occurrence of culture-proven BSI (relative risk 0.095, 95% CI 0.011–0.85, p = 0.026). Risk of culture-proven BSI in the control group was 10.545 (95% CI 1.227–90.662, p = 0.026). BSI occurred in 75% of neonates without risk factors of infection in the control group compared to none in the study group.Conclusion: The use of a closed catheter access system reduced the BSI in low birth weight preterm infants. Choosing the right device design, proper disinfection of device, and appropriate frequency of connector change should be done simultaneously.

Pos-654 the Two Years of Hemodialysis Vascular Access Catheter Insertion in Banjarmasin, Indonesia

“…In the USA, CLABSI rate in intensive care units is estimated to be 0.8/ 1000 central line days. 2,3 Our study is only 2.31% of infection and no differences between temporary, tunneled, and among temporary with different location. CLABSI is a major cause for longer hospital stay, increased costs, and the high mortality rate.…”

“…In comparison, 2012, Cipto Mangunkusumo Hospital Jakarta, Indonesia reported a BSI rate of 12.88/1000 catheter days, and then a slight decrease in 2013 to 10.53 BSIs/ 1000 catheter days. 3 Conclusions: The insertion hemodialysis vascular access catheter was newly reported about 2 years in Banjarmasin, Indonesia. There were no differences of infection between tunneled, temporary, and different location in temporary catheter insertion.…”