Central Line-Associated Bloodstream Infections in Pediatric Intensive Care Unit

Abstract

Introduction:The aim of this study was to determine the frequency of central line-associated bloodstream infections, risk factors, their relationship with catheter insertion location, and the effect of central line-associated bloodstream infections on mortality and pediatric intensive care unit (PICU) length of stay. Methods: This was a prospective, observational and cohort study, carried out between November 2009 and February 2011. During this period, all the patients who had central-line were monitored for central line-associated bloodstream infection. Results: In the study period, 275 patients were admitted to our PICU. The frequency of invasive device usage was 38.9% (107) for central venous catheter, 38.2% (105) for mechanical ventilation, 53.3% (147) for urinary catheter, and 11.3% (32) for artery line. Central lineassociated bloodstream infection was detected in 16 (14.8%) of the patients and 23 central line-associated bloodstream infection attacks were observed. There were 14 central line-associated bloodstream infection attacks in 1.000 central venous catheter usage days. There were 168 patients without central venous catheter and 4 (2.4%) of them had blood stream infection. Thirty-six patients died and the mortality rate was 13%. Five of these patients (13.8%) died due to central line-associated bloodstream infection, 27 (25%) of them had central venous catheter and 9 (6%) of them did not (p=0.001). Conclusion:In conclusion, central line-associated bloodstream infection is one of the serious healthcare-associated infections, and it is an important cause of morbidity and mortality in PICUs. Keywords: Nosocomial infection, central line-associated bloodstream infection, pediatric intensive careGiriş: Bu çalışmanın amacı, kateter ilişkili kan dolaşımı enfeksiyonlarının sıklığını, risk faktörlerini, kateter yerleştirme yerleri ile olan ilişkisini, ayrıca bu enfeksiyonların mortalite ve çocuk yoğun bakım ünitesi (ÇYBÜ) kalış süresine olan etkisini belirlemektir. AbstractÖz

Can inverse probability treatment weighting (IPTW) be used to assess differences of CRBSI rates between non-tunneled femoral and jugular CVCs in PICU patients?

“…According to our study, the sample's median age was 12 months (IQR 4 to 72). It is lower than many other published data points [62][63][64], and men dominate, as they do in most research papers [64]. Furthermore, the CRBSI rate is noteworthy because it's higher than a few [62,65] but lower than the majority of the research articles [63,64,[66][67][68] In addition, we observed a CRBSI rate of 4.10 for 1463 central line days, but we predicted 1.902 for the same days.…”

A multidisciplinary intervention to reduce central line-associated bloodstream infection in pediatrics and neonatal intensive care units

“…35 Similarly, a Turkish study showed a mean duration of central line use among the studied population 14 AE 9.7 days. 36 An amazing finding was reporting a zero MDRO identified among the isolated pathogens in the post-intervention phase. Other investigations, however, done in Egypt, Greece, Turkey, and Brazil, have not revealed such results, demonstrating that the majority of the organisms isolated were gram-negative, with a significant percentage of these organisms being MDRO.…”

“…Other investigations, however, done in Egypt, Greece, Turkey, and Brazil, have not revealed such results, demonstrating that the majority of the organisms isolated were gram-negative, with a significant percentage of these organisms being MDRO. 21,26,34,36 This achievement greatly impacted patients' management and duration of ICUs stay not only on those developed infection but also on all admitted patients as the good practice and compliance extended everywhere. The current study found that, despite the fact that our intensive care units are unique in terms of patient characteristics and serve the entire country, the team was able to review the need for central lines, prompt removal of unnecessary lines, reduce the duration of central line use, and, as a result, the CLABSI rate.…”

Incidence and Risk Factors of Nosocomial Bloodstream Infections in Pediatric Intensive Care Unit

“…22 Santral venöz kateter ilişkili KDE hastane ilişkili enfeksiyonların önemli nedenlerindendir. 23 Çalışmamızda SVK takılan ve mekanik ventilasyon uygulanan hastalarda daha sık nozokomiyal KDE saptanmıştır. Elward ve Fraser'in 14 aynı anda birden fazla SVK kullanımının KDE riskini daha da artırdığını bildirmiştir.…”