Significant Reduction of Catheter-associated Blood Stream Infections in Preterm Neonates After Implementation of a Care Bundle Focusing on Simulation Training of Central Line Insertion

Steiner, Manuel; Langgartner, Michaela; Cardona, Francesco; Waldhör, Thomas; Schwindt, Jens; Haiden, Nadja; Berger, Angelika

doi:10.1097/inf.0000000000000841

Cited by 43 publications

(43 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This disparity may also be attributed to contamination of catheter insertion sites, resulting in central line-associated bloodstream infections (CLABSI). Employing CVC bundles have shown to significantly reduce CLABSI rates 17. The introduction of a hand hygiene policy and a CVC care bundle in our centre contributed to a 71% decrease in postoperative infections during the IQIC period.…”

Section: Discussionmentioning

confidence: 88%

Impact of International Quality Improvement Collaborative on Congenital Heart Surgery in Pakistan

Khan

Abdullah

Ahmad

et al. 2017

Heart

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 88%

Impact of International Quality Improvement Collaborative on Congenital Heart Surgery in Pakistan

Khan

Abdullah

Ahmad

et al. 2017

Heart

View full text Add to dashboard Cite

show abstract

“…In our patients, CLABSI is the second cause of sepsis. It is difficult to compare CLABSI incidence rate (5.5 par 1000 line days) to the neonatal literature (ranging between 1.43 and 11 per 1000 line days), considering that most studies include neonates from all terms (including very low birth weights) and that most neonatal units are using preferentially PICC and not centrally inserted CVC as routine practice [21–25]. Nevertheless, neonatal CLABSI incidence rates are mainly caused by S. epidermidis and S. aureus [26].…”

Section: Discussionmentioning

confidence: 99%

Sepsis risk factors in infants with congenital diaphragmatic hernia

Levy

Saché

Mokhtari³

et al. 2017

Ann. Intensive Care

View full text Add to dashboard Cite

BackgroundCongenital diaphragmatic hernia (CDH) is a rare congenital anomaly and remains among the most challenging ICU-managed disease. Beside severe pulmonary hypertension, lung hypoplasia and major abdominal surgery, infective complications remain major determinants of outcome. However, the specific incidence of sepsis as well as associated risk factors is unknown.MethodsThis prospective, 4-year observational study took place in the pediatric intensive care and neonatal medicine department of the Paris South University Hospitals (Le Kremlin-Bicêtre, France), CDH national referral center and involved 62 neonates with CDH.Main resultsDuring their ICU stay, 28 patients (45%) developed 38 sepsis episodes. Ventilator-associated pneumonia (VAP: 23/38; 31.9 VAP per 1000 days of mechanical ventilation) and central line-associated blood stream infections (CLABSI: 5/38; 5.5 per 1000 line days) were the most frequently encountered infections. Multivariate analysis showed that gestational age at birth and intra-thoracic position of liver were significantly associated with the occurrence of sepsis. Infected patients had longer duration of mechanical and noninvasive ventilation (16.2 and 5.8 days, respectively), longer delay to first feeding (1.2 days) and a longer length of stay in ICU (23 days), but there was no difference in mortality.ConclusionsHealthcare-associated infections, and more specifically VAP, are the main infective threat in children with CDH. Sepsis has a significant impact on the duration of ventilator support and ICU length of stay but does not impact mortality. Low gestational age and intra-thoracic localization of the liver are two independent risk factors associated with sepsis.Electronic supplementary materialThe online version of this article (doi:10.1186/s13613-017-0254-9) contains supplementary material, which is available to authorized users.

show abstract

“…While sepsis episodes with coagulase-negative staphylococci were significantly reduced, the rate of MSSA infections remained unchanged [10]. Consequently, we introduced an MSSA screening and decolonization protocol in January 2014.…”

Section: Introductionmentioning

confidence: 99%

Active Surveillance Cultures and Targeted Decolonization Are Associated with Reduced Methicillin-Susceptible <b><i>Staphylococcus aureus</i></b> Infections in VLBW Infants

et al. 2017

Self Cite

View full text Add to dashboard Cite

Background: Methicillin-susceptible Staphylococcus aureus (MSSA) is a major contributor to infectious episodes of very low birth weight infants (VLBWI), resulting in significant morbidity and mortality. Objective: To examine the efficacy and safety of surveillance cultures and the decolonization of MSSA-colonized VLBWI. Methods: VLBWI admitted to our neonatal wards in 2011-2016 were retrospectively analyzed. Rates of MSSA-attributable infections were compared before and after the implementation of active surveillance cultures and the decolonization of MSSA-colonized patients. The mupirocin susceptibility of isolated MSSA strains was routinely tested. Results: A total of 1,056 VLBWI were included in the study, 552 in the pre-intervention period and 504 in the post-intervention period. The implementation of surveillance cultures and decolonization of colonized patients resulted in a 50% reduction of incidence rates per 1,000 patient-days of MSSA-attributable infections (1.63 [95% CI 1.12-2.31] vs. 0.83 [95% CI 0.47-1.35], p = 0.024). No adverse effects were observed from application of the decolonization protocol with mupirocin and octenidin. No mupirocin-resistant MSSA strains were detected during the study period. Conclusion: Implementation of an active surveillance and decolonization protocol resulted in a reduction of MSSA-attributable infections in VLBWI.

show abstract

Significant Reduction of Catheter-associated Blood Stream Infections in Preterm Neonates After Implementation of a Care Bundle Focusing on Simulation Training of Central Line Insertion

Abstract: Our data provide evidence of a potential effect of simulation-based training of central line placement in decreasing CLABSI rates in VLBWI and encourage its implementation into care bundles.

Cited by 43 publications

References 16 publications

Impact of International Quality Improvement Collaborative on Congenital Heart Surgery in Pakistan

Impact of International Quality Improvement Collaborative on Congenital Heart Surgery in Pakistan

Sepsis risk factors in infants with congenital diaphragmatic hernia

Active Surveillance Cultures and Targeted Decolonization Are Associated with Reduced Methicillin-Susceptible <b><i>Staphylococcus aureus</i></b> Infections in VLBW Infants

Contact Info

Product

Resources

About