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Central Line–Associated Bloodstream Infection in Neonatal Intensive Care Units

  • Ana C. Blanchard (a1), Elise Fortin (a2) (a3), Isabelle Rocher (a2), Dorothy L. Moore (a1), Charles Frenette (a4), Claude Tremblay (a5) and Caroline Quach (a1) (a2) (a3) (a4)...

Abstract

Objective.

Describe the epidemiology of central line-associated bloodstream infections (CLABSIs) in neonatal intensive care units (NICUs) participating in a standardized and mandatory CLABSI surveillance program.

Design.

Retrospective cohort.

Setting.

We included patients admitted (April 2007-March 2011) to 7 level II/III NICUs who developed a CLABSI (as defined by the National Healthcare Safety Network).

Methods

. CLABSIs/1,000 central line–days and device utilization ratio were calculated; x2 test, Student t test, Kruskal-Wallis, and Poisson regression were used.

Results.

Overall, 191 patients had 202 CLABSI episodes for a pooled mean rate of 4.0 CLABSIs/1,000 central line-days and a device utilization ratio of 0.20. Annual pooled mean CLABSI rates increased from 3.6 in 2007-2008 to 5.1 CLABSIs/1,000 central line-days in 2010-2011 (P = .01). The all-cause 30-day case fatality proportion was 8.9% (n = 17) and occurred a median of 8 days after CLABSI. Coagulase-negative Staphylococcus was identified in 112 (50.5%) cases. Staphylococcus aureus was identified in 22 cases, and 3 (13.6%) were resistant to methicillin. An underlying intra-abdominal pathology was found in 20% (40/202) of CLABSI cases, 50% of which were reported in the last year of study. When adjusted for mean birth weight, annual CLABSI incidence rates were independently associated with the proportion of intra-abdominal pathology (P = .007) and the proportion of pulmonary pathology (P = .016) reported.

Conclusion.

The increase in CLABSI rates in Quebec NICUs seems to be associated with an increased proportion of cases with underlying intra-abdominal and pulmonary pathologies, which needs further investigation.

Copyright

Corresponding author

Montreal Children's Hospital, 2300 Tupper Street, Room C1242, Montreal, Quebec H3H 1P3, Canada (caroline.quach@mcgill.ca)

References

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Infection Control & Hospital Epidemiology
  • ISSN: 0899-823X
  • EISSN: 1559-6834
  • URL: /core/journals/infection-control-and-hospital-epidemiology
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