The Frequency of Multiple Central Line-Associated Bloodstream Infections (CLABSIs) Occurring in the Same Child: A Five-Year Experience.

Abstract

Background: The aim of this study was to evaluate one institution's five-year experience with the frequency of multiple central line-associated bloodstream infections (CLABSIs) occurring in the same child and to discuss the importance of previous CLABSI as a risk factor for future CLABSI and the implications for CLABSI rate calculation.

Methods: The infection surveillance system includes data on central line days, CLABSI rate, and CLABSI count, including mucosal barrier injury (MBI) and non-MBI CLABSIs. Using this data, the authors determined the number of children who had more than one inpatient CLABSI during a five-year period. The team then calculated the percentage of total CLABSIs that are represented by patients with more than one CLABSI and the percentage of patients with CLABSI who had multiple CLABSIs.

Results: During the five-year study period, there were 138 CLABSIs in 119 patients. Of the 138 CLABSIs, 36 (26.1%) occurred in children who had more than one CLABSI and 19 (13.8%) of those were repeat. Seventeen patients had more than 1 inpatient CLABSI (15 patients with 2 CLABSIs, and 2 patients with 3 CLABSIs). The CLABSI rate for this period was 1.83 per 1,000 central line days. With exclusion of repeat CLABSIs, the CLABSI rate would be 1.58 per 1,000 central line days, representing a 13.7% difference.

Conclusion: Repeat CLABSI in the same patient is not uncommon and can contribute significantly to overall inpatient CLABSI rates. Prior CLABSI should be considered a risk factor for future CLABSI.