Patients with Psychiatric Disorders Can Also Have CLABSIs: A Response to “CLABSI or Munchausen’s or Both”

Brooks, Erin; Christy, Nancy E.; Mack, A.H.; McFadden, Mary

doi:10.1017/ice.2015.72

Cited by 1 publication

(1 citation statement)

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“…Previous reports have made a case for special consideration of CLABSI risk in these patients. 27 Behavioral health needs are an important issue for pediatric patients, with nearly 500,000 pediatric admissions annually including behavioral disorders. 28 Accounting for 3%-10% of pediatric admissions, pediatric inpatient mental health is emerging as a priority topic for quality improvement and measurement on a national scale.…”

Section: Discussionmentioning

confidence: 99%

Novel risk factors for central-line associated bloodstream infections in critically ill children

Woods-Hill

Srinivasan

Schriver

et al. 2019

Infect. Control Hosp. Epidemiol.

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Objective:Central-line–associated bloodstream infections (CLABSI) cause morbidity and mortality in critically ill children. We examined novel and/or modifiable risk factors for CLABSI to identify new potential targets for infection prevention strategies.Methods:This single-center retrospective matched case-control study of pediatric intensive care unit (PICU) patients was conducted in a 60-bed PICU from April 1, 2013, to December 31, 2017. Case patients were in the PICU, had a central venous catheter (CVC), and developed a CLABSI. Control patients were in the PICU for ≥2 days, had a CVC for ≥3 days, and did not develop a CLABSI. Cases and controls were matched 1:4 on age, number of complex chronic conditions, and hospital length of stay.Results:Overall, 72 CLABSIs were matched to 281 controls. Univariate analysis revealed 14 risk factors, and 4 remained significant in multivariable analysis: total number of central line accesses in the 3 days preceding CLABSI (80+ accesses: OR, 4.8; P = .01), acute behavioral health needs (OR, 3.2; P = .02), CVC duration >7 days (8–14 days: OR, 4.2; P = .01; 15–29 days: OR, 9.8; P < .01; 30–59 days: OR, 17.3; P < .01; 60–89 days: OR, 39.8; P < .01; 90+ days: OR, 4.9; P = .01), and hematologic/immunologic disease (OR, 1.5; P = .05).Conclusions:Novel risk factors for CLABSI in PICU patients include acute behavioral health needs and >80 CVC accesses in the 3 days before CLABSI. Interventions focused on these factors may reduce CLABSIs in this high-risk population.

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Section: Discussionmentioning

confidence: 99%