Risk Factors for Central Line-Associated Bloodstream Infection in Critically Ill Neonates

García, Heladia; Romano-Carro, Belina; Novales, María Guadalupe Miranda; González-Cabello, Héctor Jaime; Núñez-Enríquez, Juan Carlos

doi:10.1007/s12098-019-02896-6

Cited by 12 publications

(11 citation statements)

References 29 publications

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“…32,33 In children, most common microorganisms causing CRBSIs are Gram-positive bacteria, mainly CONS, S. aureus, and Enterococcus faecalis, followed by Gram-negative bacteria: K. pneumoniae, E. coli, Enterobacter cloacae, and P. aeruginosa. 15,26 In our study, the microbiological profile of culture isolates in CRBSI patients was similar. CONS was the most frequently isolated organism, similar to other publications.…”

Section: Discussionsupporting

confidence: 62%

“…In general, surgical procedures are considered risk factors for the development of any type of healthcare-associated infections. 15 Previous studies from various ICU settings have shown an increased risk of CRBSI in patients with gastrointestinal conditions. 16 17 18 In the PICNIC study, 19 the authors reported active intra-abdominal pathology (OR = 3.4; 95% CI: 1.8–6.4) and abdominal surgery in the prior 7 days (OR = 3.5; 95% CI: 1.0–10.9) as one of the main independent risk factors for CRBSI.…”

Section: Discussionmentioning

confidence: 99%

“…The postoperative status of the patients after correction of gastrointestinal tract malformations and prolonged fasting could account for some of these infections with a probable endogenous origin. 15 Another common source of infection is the microbial biofilm formed in the catheter lumen from contamination, either from the infusate or the catheter hub, detachment of which may lead to CRBSI. As biofilms are resistant to routine systemic antimicrobial therapy, the use of antimicrobial locking solutions has been reported to be beneficial in reducing the incidence of CRBSI.…”

Section: Discussionmentioning

confidence: 99%

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Central Venous Catheter-Related Infectious Complications in Pediatric Surgical Patients: A Single-Center Experience

Haldar

Mandelia

Mishra

et al. 2021

J Pediatr Intensive Care

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The purpose of this study was to estimate the rate of central venous catheter (CVC) colonization and catheter-related bloodstream infections (CRBSIs) in pediatric surgical patients at our institute and to determine the various risk factors for their occurrence. The electronic medical records of 260 children undergoing surgery with simultaneous CVC insertion were retrospectively reviewed. Data on demographics, primary organ system involved, site of CVC, CVC dwell time, CVC colonization, CRBSI, and organisms isolated on culture were collated, categorized, and analyzed. The rate of CVC colonization and CRBSI was 32.8 per 1,000 catheter days (19.6%) and 17.4 per 1,000 catheter days (10.4%), respectively. Patients with CVC colonization and CRBSI had a significantly higher proportion of patients younger than 1 year of age (p = 0.014). The CVC dwell time was significantly higher in both CVC colonization (7 [5–8] days) and CRBSI (6 [5–9] days) patients (p = 0.005). The frequency of femoral catheterization was significantly higher in patients with CRBSI and CVC colonization (p < 0.001). Coagulase negative staphylococcus was the commonest isolate in CVC infections. Age (adjusted odds ratio [OR] = 0.87; p = 0.009), CVC dwell time (adjusted OR = 1.28; p = 0.003), and femoral CVC (adjusted OR = 9.61; p < 0.001) were independent risk factors for CRBSI. Conclusion: This study reveals important observations regarding the infectious complications of CVC in pediatric surgical patients. The rates of CVC colonization and CRBSI in this study were found to be higher as compared with previously reported rates in Western literature. However, these findings are significant in view of paucity of existing literature in pediatric surgical patients. In our study, higher risk of CRBSI was associated with younger age, increasing CVC dwell time, and femoral venous catheterization. We recommend strict compliance with CVC insertion and maintenance practices and adherence to CVC care bundles to minimize these serious complications.

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Section: Discussionsupporting

confidence: 62%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Central Venous Catheter-Related Infectious Complications in Pediatric Surgical Patients: A Single-Center Experience

Haldar

Mandelia

Mishra

et al. 2021

J Pediatr Intensive Care

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“…Previous studies regarding HAIs in the ICU setting also have limitations. Most employed small sample sizes and reported a very small number of events 13,29–32. For instance, one study, suggested no significant association between VAE and the timing of rehabilitation, included only 294 patients, among which 29 patients developed VAE 30.…”

Section: Discussionmentioning

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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“…Se utilizaron dos fichas digitalizadas con una interfaz en Microsoft Access©. Ambas fichas fueron previamente validadas por el servicio de la UCIN, teniendo en cuenta factores de riesgo reportados previamente en la literatura (12,13) . Las mediciones fueron obtenidas mediante procedimientos estandarizados, utilizando un mismo instrumento para todos los participantes, los datos referentes al catéter fueron obtenidos de la historia clínica del paciente.…”

Section: Instrumentos Y Recolección De Informaciónunclassified

Incidencia y factores de riesgo de infecciones del torrente sanguíneo asociadas a catéter central

Cabrera

Cuba

Hernandez

et al. 2021

Rev Peru Med Exp Salud Publica

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Las infecciones del torrente sanguíneo asociadas a catéter central (ITSACC) generan gran morbimortalidad y elevados costos hospitalarios. Estudios sobre su incidencia y comportamiento clínico-epidemiológicos en la población neonatal en el Perú son escasos y no está del todo claro su impacto actual. Se realizó un estudio de cohorte prospectivo durante un año (2017-2018) en la unidad de cuidados intensivos (UCI) neonatales de un hospital público de Lima, Perú. Se incluyeron 167 pacientes (52,7% varones) con edades gestacionales entre las 24-41 semanas, se registraron 1999 días-catéter y 16 casos de ITSACC. La incidencia fue de 8/1000 días-catéter. El uso de catéter umbilical (p=0,005) y el uso de múltiples catéteres (p0,001) mostraron relación estadísticamente significativa respecto al desarrollo de ITSACC. Es necesario ampliar el estudio a otras UCI y establecer sistemas eficientes y duraderos de monitoreo que permitan la evaluación de intervenciones para reducir las ITSACC.

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Risk Factors for Central Line-Associated Bloodstream Infection in Critically Ill Neonates

Cited by 12 publications

References 29 publications

Central Venous Catheter-Related Infectious Complications in Pediatric Surgical Patients: A Single-Center Experience

Central Venous Catheter-Related Infectious Complications in Pediatric Surgical Patients: A Single-Center Experience

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

Incidencia y factores de riesgo de infecciones del torrente sanguíneo asociadas a catéter central

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