Very low birthweight infants face an increased risk of bloodstream infections following the removal of umbilical catheters

Lindquist, Simon; Hentz, Elisabet; Tessin, Ingemar; Elfvin, Anders

doi:10.1111/apa.13240

Cited by 13 publications

(7 citation statements)

References 24 publications

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“…Due to a strong collinear relationship, the duration of PN and PICC dwelling time was entered into the logistic regression model only one parameter at a time. Gestational age and birth weight were mentioned as important influencing factors in many works of literature [26][27][28] , so they were included in the model for statistics. Then multivariate logistic regression was performed to calculate the adjusted odds ratios (ORs) and 95% confidence intervals (CI).…”

Section: Discussionmentioning

confidence: 99%

Risk Factors and Clinical Analysis for PICC Related Fungal Colonization in Premature Infants

Zhang

Yang

Dong

et al. 2021

Preprint

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Objective: The present study aimed to analyze the risk factors for positive peripherally inserted central catheter (PICC) related fungal colonization in preterm infants. Methods: A retrospective study was conducted in a tertiary hospital in southwest China between January 1, 2018 and December 31, 2020. The enrolled infants who underwent ultrasound-guided PICC insertion during hospitalization were born at < 32 weeks gestation or birth weight < 1500 grams. The demographics, the PICC related characteristics, the use of antibiotic, glucocorticoid and parenteral nutrition (PN) were collected from the medical record. Univariate and multivariate analyses were performed to investigate risk factors for PICC-related fungal colonization. Receiver operating characteristic (ROC) curve was used to determine the optimal cut-off value by calculating the Yoden index. Results: A total of 124 premature infants underwent ultrasound-guided PICC insertion. Among them, 19 patients had positive results of fungi at PICC tips.PN infusion duration (OR 1.37, 95%CI 1.05-1.79) and postnatal glucocorticoid exposure(OR 9.19, 95%CI 1.04-81.65) were independent risk factors for fungal colonization in PICC. The optimal cut-off value was 15days,28days, respectively. Conclusion: PICC tips fungal colonization is affected by postnatal glucocorticoid exposure and PN infusion duration. Appropriate clinical management should be adopted to avoid fungal colonization and fungemia.

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Section: Discussionmentioning

confidence: 99%

Risk Factors and Clinical Analysis for PICC Related Fungal Colonization in Premature Infants

Zhang

Yang

Dong

et al. 2021

Preprint

View full text Add to dashboard Cite

show abstract

“…Because they had a strong collinear relationship, the PICC dwelling time and duration of PN were entered into the logistic regression model only one parameter at a time. Gestational age and birth weight were mentioned as important influencing factors in many works of literature 37 – 39 , so they were included in the model for statistical analysis. Then multivariate logistic regression was performed to calculate the adjusted odds ratios and 95% confidence intervals.…”

Section: Methodsmentioning

confidence: 99%

Risk factors and clinical analysis of peripherally inserted central catheter-related fungal colonization in premature infants

Zhang

Yang

Dong

et al. 2021

Sci Rep

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We aimed to analyze the risk factors of positive peripherally inserted central catheter (PICC)-related fungal colonization in preterm infants. This retrospective study collected data from 2018 to 2020. The enrolled infants who underwent PICC insertion were born at < 32 weeks’ gestation or birth weight < 1500 g. The demographics, PICC-related characteristics, and treatment information were collected. Univariate and multivariate analyses were performed to investigate risk factors for PICC-related fungal colonization. The receiver operating characteristic (ROC) curve was used to determine the optimal cut-off values for the duration of antibiotics and parenteral nutrition. In total, 124 premature infants underwent PICC insertion. Among them, 19 patients had positive results of fungi on the PICC tips. The duration of antibiotics (odds ratio [OR] 1.16, 95% confidence interval [CI] 1.02–1.31), parenteral nutrition infusion (OR 1.27, 95% CI 1.05–1.54), and postnatal glucocorticoid exposure (OR 9.48, 95% CI 1.06–84.98) were independent risk factors for fungal colonization in PICCs. The ROC curves showed that the risk increased after 15 days of antibiotic use and 28 days of parenteral nutrition infusion. Appropriate clinical management should be used to prevent fungal colonization and fungemia.

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“…Patent ductus arteriosus was defined as having received medical or surgical treatment of ductus, and necrotising enterocolitis (NEC) as NEC stage ≥2A based on the modified Bell NEC staging criteria. 17 Antibiotic treatment episodes were classified as: (1) culture-positive sepsis, bacteraemia with a recognised pathogen and clinical symptoms; (2) sepsis with coagulase-negative Staphylococcus spp (CoNS), bacteraemia with CoNS and fulfilled Yale-criteria for CoNS infection 18 ; (3) culture-negative infections, negative or absent blood cultures but fulfilled criteria for clinical sepsis according to Lindquist et al (signs of infection (apnoea, bradycardia, gastric retention or hypothermia) with ≥1 of the following: interleukin (IL)-6 ≥1000 mg/L in infants less than 3 days of age, IL-6 ≥100 mg/L in infants ≥3 days of age, C reactive protein ≥20 mg/L, white cell count <5 x 10 9 /L or >30 x 10 9 /L), 19 documented skin infection, thrombophlebitis, NEC or other confirmed diagnosis; (4) unconfirmed infection, not fulfilling any of the above criteria.…”

Section: Data Collectionmentioning

confidence: 99%

Reduced antibiotic use in extremely preterm infants with an antimicrobial stewardship intervention

Gustavsson

Lindquist

Elfvin

et al. 2020

bmjpo

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IntroductionExcessive administration of antibiotics to preterm infants is associated with increased rates of complications. The purpose of the study was to evaluate the effect of an antimicrobial stewardship intervention on antibiotic use in extremely preterm infants.Design, setting, patients and interventionA before and after study of infants born at ≤28 weeks’ gestational age was performed in the neonatal intensive care unit of Queen Silvia’s Children’s Hospital, Gothenburg, Sweden. Retrospective analysis of the baseline period (January–December 2014) guided the development of a limited antimicrobial stewardship intervention. The intervention consisted of updated local guidelines with a focus on shortened and standardised treatment duration plus increased access to infectious disease consultant advice. It was fully implemented during the intervention period (October 2017–September 2018).ObjectivePrimary aim was to compare antibiotic use, defined as antibiotic treatment days per 1000 patient-days, between the two periods, and the secondary aim was to evaluate the number of days with meropenem-based regimens before and after the intervention.ResultsWe included 145 infants with a median birth weight of 870 g and median gestational age of 26 weeks. The baseline period comprised 82 infants and 3478 patient-days, the intervention period comprised 63 infants and 2753 patient-days. Overall antibiotic use (treatment and prophylaxis) was 534 versus 466 days per 1000 patient-days during the baseline and intervention periods, respectively. Antibiotic treatment days decreased from 287 to 197 days per 1000 patient-days. The proportion of meropenem-based regimens was 69% versus 44%, respectively. No increases in mortality or reinitiation of antibiotics were seen.ConclusionsImplementation of a limited antimicrobial stewardship intervention anchored in analysis of previous prescription patterns can contribute to safe decreases in antibiotic use in extremely preterm infants.

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Very low birthweight infants face an increased risk of bloodstream infections following the removal of umbilical catheters

Abstract: This NICU study demonstrated a temporal association between removing umbilical catheters and BSI in very low birthweight infants weighting <1500 g.

Cited by 13 publications

References 24 publications

Risk Factors and Clinical Analysis for PICC Related Fungal Colonization in Premature Infants

Risk Factors and Clinical Analysis for PICC Related Fungal Colonization in Premature Infants

Risk factors and clinical analysis of peripherally inserted central catheter-related fungal colonization in premature infants

Reduced antibiotic use in extremely preterm infants with an antimicrobial stewardship intervention

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