Hostname: page-component-848d4c4894-nmvwc Total loading time: 0 Render date: 2024-06-21T05:59:47.253Z Has data issue: false hasContentIssue false

Intravascular Catheter Colonization and Related Bloodstream Infection in Critically III Neonates

Published online by Cambridge University Press:  21 June 2016

Wendy A. Cronin
Affiliation:
Department of Internal Medicine, Hospital Epidemiology, the University of Virginia Health Sciences Center, Charlottesville, Virginia
Teresa P. Germanson
Affiliation:
Department of Neurosurgery, the University of Virginia Health Sciences Center, Charlottesville, Virginia
Leigh G. Donowitz*
Affiliation:
Department of Pediatrics, the University of Virginia Health Sciences Center, Charlottesville, Virginia
*
Department of Pediatrics, Box 386, University of Virginia, Health Sciences Center, Charlottesville, VA 22908

Abstract

Intravascular catheter tip colonization was prospectively evaluated in critically ill neonates to determine its relationship to the type of device used, duration of catheterization, insertion site and nosocomial bloodstream infection. Sixty-one percent (376 of 621) of all intravascular catheter tips were retrieved from 91 infants. Thirteen percent (41 of 310) of peripheral intravenous, 14% (6 of 42) of umbilical, 21% (3 of 11) of central venous, 36% (4 of 11) of peripheral arterial and 100% (2 of 2) of femoral catheters were colonized. Duration of catheterization was significantly longer for colonized lines (p < .001). Eight of 26 (30.8%) peripheral intravenous catheters remaining in place for more than three days were colonized, compared with 33 of 284 (11.6%) at three days or less (p = 0.012). Coagulase-negative staphylococcus was the organism most frequently isolated from catheter tips and bloodstream infections. Catheter colonization rates in this population were higher than those found in adults. Heavily manipulated devices and those in place for longer periods of time were the most frequently colonized.

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1990

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Hamory, BH. Nosocomial bloodstream and intravascular device-related infections. In: Wenzel, RP, ed. Prevention and Control of Nosocomial Infections. Baltimore, Md: Williams and Wilkins; 1987:283319.Google Scholar
2. Maid, DG, Weise, CE, Sarafin, HW. A semiquantitative culture method for identifying' intravenous catheter-related infection. N Engl J Med. 1977;296:13051309.Google Scholar
3. Simmons, BP. CDC guidelines for the prevention and control of nosocomial infections: guideline for prevention of intravascular infections. Am J infect Control. 1983;11:183199.CrossRefGoogle ScholarPubMed
4. Garland, JST Nelson, DB, Cheah, T, Hennes, HH, Johnson, TM. Infectious complications during peripheral intravenous therapy with Tfeflon catheters: a prospective study. Pediatr Infect Dis. 1987;6:918921.CrossRefGoogle ScholarPubMed
5. Adam, RD, Edwards, LD, Becker, CC, Schrom, HM. Semiquantitative cultures and routine tip cultures on umbilical catheters. J Pediatr. 1982;100:123126.CrossRefGoogle ScholarPubMed
6. Katich, M, Band, J. Local infection of the intravenous cannula wound associated with transparent dressings. J Infect Dis. 1985;151:971972.CrossRefGoogle Scholar
7. Singh, S, Nelson, N, Acosta, I, Check, RE, Pun, VK. Catheter colonization and bacteremia with pulmonary and arterial catheters. Crit Core Med. 1982;10:736739.CrossRefGoogle ScholarPubMed
8. Stenzel, JP, Green, TP, Fuhrman, BP, Carlson, PE, Marchessault, RP. Percutaneous central venous catheterization in a pediatric intensive care unit: a survival analysis of complications. Crit Core Med. 1989;17:984988.CrossRefGoogle Scholar
9. Maid, DG, Goldmann, DA, Rhame, FS. Infection control in intravenous therapy. Ann Intern Med. 1973;79:867887.Google Scholar
10. Donowitz, LG, Wenzel, RP, Hoyt, JW. Neonatal intensive care unit bacteremia: emergence of gram-positive bacteria as major pathogens. Am J Infect Control. 1987;15:141147.CrossRefGoogle ScholarPubMed
11. Townsend, TR, Wenzel, RP. Nosocomial bloodstream infections in a newborn intensive care unit: a case-matched control study of morbidlty, mortality and risk. Am J Epidemiol. 1981;114:7380.CrossRefGoogle Scholar
12. Giger, O, Charilaou, CC, Cundy, KR. Comparison of the API Staph-and DMS Staph-Trac System with conventional methods used for the identification of coagulase-negative staphylococcus. J Clin Microbiol. 1984;19:6872.CrossRefGoogle Scholar