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Microbiology and Risk Factors for Catheter Exit-Site and -Hub Colonization in Neonatal Intensive Care Unit Patients

Published online by Cambridge University Press:  02 January 2015

Ludo M. Mahieu ,
Jozef J. De Dooy ,
Aimé O. De Muynck ,
Guillaume Van Melckebeke ,
Margareta M. Ieven  and
Patrick J. Van Reempts
Ludo M. Mahieu*
Affiliation:
Departments of Pediatrics, Institute of Tropical Medicine, Antwerp, Belgium
Jozef J. De Dooy
Affiliation:
Departments of Pediatrics, Institute of Tropical Medicine, Antwerp, Belgium
Aimé O. De Muynck
Affiliation:
Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
Guillaume Van Melckebeke
Affiliation:
Departments of Pediatrics, Institute of Tropical Medicine, Antwerp, Belgium
Margareta M. Ieven
Affiliation:
Division of Neonatology, and Clinical Microbiology, University Hospital of Antwerp, Institute of Tropical Medicine, Antwerp, Belgium
Patrick J. Van Reempts
Affiliation:
Departments of Pediatrics, Institute of Tropical Medicine, Antwerp, Belgium
*
Department of Pediatrics, Division of Neonatology, University Hospital of Antwerp, Wilrijkstraat 10, B-2650 Antwerp, Belgium
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Abstract

Objective:

To identify risk factors and describe the microbiology of catheter exit-site and hub colonization in neonates.

Design:

During a period of 2 years, we prospectively investigated 14 risk factors for catheter exit-site and hub colonization in 862 central venous catheters in a cohort of 441 neonates. Cultures of the catheter exit-site and hub were obtained using semiquantitative techniques at time of catheter removal.

Setting:

A neonatal intensive care unit at a university hospital.

Results:

Catheter exit-site colonization was found in 7.2% and hub colonization in 5.3%. Coagulase-negative staphylococci were predominant at both sites. Pathogenic flora were found more frequently at the catheter hub (36% vs 14%; P<.05). Through logistic regression, factors associated with exit-site colonization were identified as umbilical insertion (odds ratio [OR], 8.1; 95% confidence interval [CI95], 2.35-27.6; P<.001), subclavian insertion (OR, 54.6; CI95, 12.2-244; P<.001), and colonization of the catheter hub (OR, 8.9; CI95,3.5-22.8; P<.001). Catheter-hub colonization was associated with total parenteral nutrition ([TPN] OR for each day of TPN, 1.056; CI95,1.029-1.083; P<.001) and catheter exit-site colonization (OR, 6.11; CI95, 2.603-14.34; P<.001). No association was found between colonization at these sites and duration of catheterzation and venue of insertion, physician's experience, postnatal age and patient's weight, ventilation, steroids or antibiotics, and catheter repositioning.

Conclusion:

These data support that colonization of the catheter exit-site is associated with the site of insertion and colonization of the catheter hub with the use of TPN. There is a very strong association between colonization at both catheter sites.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 22 , Issue 6 , June 2001 , pp. 357 - 362
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2001

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