Improving central line infection rates in the neonatal intensive care unit: Effect of hospital location, site of insertion, and implementation of catheter-associated bloodstream infection protocols

Journal of Pediatric Surgery
Jennifer J FreemanRonald B Hirschl

Abstract

Catheter associated blood stream infections (CABSIs) are morbid and expensive for all ages, including neonates. Thus far, the impact of CABSI prevention protocols, such as insertion and maintenance bundles, in the neonatal intensive care unit (NICU) is largely unknown. We hypothesized that lines placed in the operating room (OR) would have a lower infection rate due to established insertion protocols and a more sterile environment. A retrospective chart review of NICU patients who received a percutaneous or tunneled central venous catheter between 2005 and 2012 was performed. ECMO cannulas, PICC and umbilical catheters were excluded. Variables of interest included demographics, anatomical site, hospital location, line days, and line infection. Line infection was defined as a positive blood culture drawn through the catheter. A total of 368 catheters were placed in 285 NICU patients. Majority of catheters (65.5%) were placed in OR. Saphenous and femoral veins were most common anatomical sites (50.8%). Twenty-eight catheters were infected (7.6%). After adjusting for preoperative antibiotics, anatomical site, and SNAPPE-II scores, lines placed in OR were three times less likely to become infected (Odds Ratio=0.32, p=0.038). Althou...Continue Reading

References

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Citations

Jul 6, 2017·Frontiers in Pediatrics·Gerdina H Dubbink-VerheijEnrico Lopriore
Jul 20, 2017·Pediatric Radiology·Will S LindquesterMatthew P Lungren
Aug 10, 2019·American Journal of Perinatology·Elena Bergón-SendínMaría Teresa Moral-Pumarega
May 20, 2020·Annals of Vascular Surgery·Osama A Bawazir, Tariq I Altokhais

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