The impact of central line-specific dwell-times for neonatal central line associated bloodstream infections.

IF 4.4 2区 医学 Q1 INFECTIOUS DISEASES
Martina Buttera, Carolyn Luhmann-Lunt, Michael Buettcher, Dirk Lehnick, Martin Stocker
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Abstract

Background: Central line-associated bloodstream infections (CLABSIs) are among the most serious infectious complications associated with central lines in neonates. CLABSIs can be prevented by healthcare workers using "bundles" when inserting and managing central lines. These include prompt removal of the central line when it is no longer needed. The aim of this study was to describe and analyze neonatal CLABSIs, focusing on a minimal data set including specific catheter types and dwell times.

Methods: A retrospective descriptive study reviewing the management and outcome of neonates with CLABSI admitted to the Department of Neonatology and Neonatal Intensive Care at the Children's Hospital of Central Switzerland in Lucerne from 1 January 2020 to 31 December 2023.

Results: In this four-year period, a total of 27,636 neonates were born in the catchment area and 2599 neonates (9.4%) were admitted to our hospital. In total, 615 neonates (23.7%) had at least one central line with a total of 4940 catheter days. We observed an overall neonatal CLABSI rate of 2.9 per 1,000 catheter days. The rate varied significantly by catheter type: 0 per 1,000 catheter days for umbilical artery catheters (UACs), 0.9 per 1,000 catheter days for peripherally inserted central lines (PICCs), 5.6 per 1,000 catheter days for umbilical venous catheters (UVCs), and 17.9 per 1,000 catheter days for centrally inserted venous catheters (CVCs). All episodes of CLABSI were observed after a dwell time of 5 days, with increasing rates after 9 days.

Conclusions: We observed a pronounced variation in CLABSI rates between different catheter types. All episodes of CLABSI were observed after a dwell time of 5 days, with increasing rates after 9 days, and the rate of CLABSI increased with longer dwell times for UVCs and CVCs. This suggests a reduction in dwell time as a potential strategy for future quality improvement programs aiming for a zero CLABSI rate and underlines the importance of reporting central-line specific dwell-times for future publications.

中心线特异性停留时间对新生儿中心线相关血流感染的影响。
背景:中心线相关血流感染(CLABSIs)是新生儿与中心线相关的最严重的感染性并发症之一。医护人员可以在插入和管理中心静脉管时使用“束”来预防clabsi。这些措施包括在不再需要中央静脉导管时立即拆除。本研究的目的是描述和分析新生儿CLABSIs,重点关注最小数据集,包括特定导管类型和停留时间。方法:一项回顾性描述性研究回顾了2020年1月1日至2023年12月31日在卢塞恩瑞士中部儿童医院新生儿和新生儿重症监护室收治的CLABSI新生儿的管理和结局。结果:4年期间,该流域共出生新生儿27636例,住院新生儿2599例,占9.4%。总共有615名新生儿(23.7%)至少有一条中心静脉导管,总导管时间为4940天。我们观察到新生儿CLABSI的总发生率为2.9 / 1000导管天。不同导管类型的发生率差异显著:脐动脉导管(UACs)每1000个导管天发生率为0,外周中心静脉导管(PICCs)每1000个导管天发生率为0.9,脐静脉导管(UVCs)每1000个导管天发生率为5.6,中心静脉导管(CVCs)每1000个导管天发生率为17.9。所有CLABSI发作均在5天后观察到,9天后发生率增加。结论:我们观察到不同导管类型间CLABSI发生率的显著差异。所有CLABSI发作均在5天后观察到,9天后发生率增加,uvc和cvc的CLABSI发生率随停留时间的延长而增加。这表明,减少停留时间作为未来质量改进计划的潜在策略,旨在实现零CLABSI率,并强调了报告中央线特定停留时间对未来出版物的重要性。
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来源期刊
Antimicrobial Resistance and Infection Control
Antimicrobial Resistance and Infection Control PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH -INFECTIOUS DISEASES
CiteScore
9.70
自引率
3.60%
发文量
140
审稿时长
13 weeks
期刊介绍: Antimicrobial Resistance and Infection Control is a global forum for all those working on the prevention, diagnostic and treatment of health-care associated infections and antimicrobial resistance development in all health-care settings. The journal covers a broad spectrum of preeminent practices and best available data to the top interventional and translational research, and innovative developments in the field of infection control.
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