Author/Editor     Pavčnik Arnol, Maja
Title     #The #risk of central line-associated bloodstream infections with different types of central vascular catheters in a multidisciplinary neonatal and pediatric intensive care unit
Type     članek
Vol. and No.     Letnik 8, št. 1
Publication year     2012
Volume     str. 15-20
Language     eng
Abstract     Objective. Central line-associated bloodstream infections (CLABSIs) are a significant cause of morbidity in critically ill neonates and children. The objective of this study was to compare CLABSI rate associated with different types of central vascular catheters (CVCs) in a multidisciplinary neonatal andpediatric intensive care unit (ICU). Methods. A prospective cohort study was conducted in a multidisciplinary neonatal and pediatric ICU. All patients,admitted between January 1st 2011 and February 29th 2012, requiring aCVC were included and monitored for CLABSI (defined by CDC/NHSN criteria). CLABSI rates were calculated for each type of CVC as CLABSI episodes/1000 catheter-days. CLABSI rates were compared between patients with single and multiple CVCs. Results. Of the 557 patients admitted, 362 (65%) required insertion of a CVC (4259 patient-days, 3225 catheter-days, CVC utilization ratio 0.76). There were 14 episodes of CLABSI. CLABSI rate was lowest for umbilical catheters (0/1000 catheter-days), followed by short-term noncuffed and nontunneled CVCs (3.1/1000 catheter-days) and peripherally inserted CVCs (8.8/1000 catheter-days). Higher rates were observed with long-term cuffed andtunneled CVCs (15.9/1000 catheter days) and noncuffed, nontunneled CVCs fortemporary renal replacement therapy (RRT) (20.0/1000 catheter days). CLABSIrate expressed per 1000 catheter-days was 3.0 and 19.7 for patients withsingle or multiple CVCs at the same time, respectively. Conclusion. The use of noncuffed, nontunneled CVCs for temporary RRT and the presence of multiple CVCs at the same time are associated with a significant increase in the rate and risk of developing CLABSI in a multidisciplinary neonatal and pediatric ICU population.
Keywords     central line-associated bloodstream infections
nosocomial infections
central vascular catheter
bloodstream infections
pediatric intensive care unit
neonate
child