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Infection Control & Hospital Epidemiology Infection Control & Hospital Epidemiology

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Risk Factors for Central Venous Catheter–Associated Bloodstream Infection in Pediatric Patients: A Cohort Study

Published online by Cambridge University Press:  03 May 2016

Jillian Hansen Carter ,
Joanne Marie Langley ,
Stefan Kuhle  and
Susan Kirkland
Jillian Hansen Carter
Affiliation:
Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
Joanne Marie Langley*
Affiliation:
Department of Pediatrics, Dalhousie University, Halifax, Nova Scotia, Canada Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada Department of Obstetrics and Gynecology, Dalhousie University, Halifax, Nova Scotia, Canada
Stefan Kuhle
Affiliation:
Department of Pediatrics, Dalhousie University, Halifax, Nova Scotia, Canada Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada IWK Health Centre, Halifax, Nova Scotia, Canada Department of Obstetrics and Gynecology, Dalhousie University, Halifax, Nova Scotia, Canada
Susan Kirkland
Affiliation:
Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada
*
Address correspondence to Joanne M. Langley MD, MSc, FSHEA, IWK Health Centre, Goldbloom RCC Pavilion, 4th floor, 5850/5980 University Avenue, Halifax, NS, Canada B3K 6R8 (joanne.langley@dal.ca).
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Abstract

OBJECTIVE

To examine the incidence of central-line–associated bloodstream infection (CLABSI) over time and to determine risk factors for CLABSI in hospitalized children.

DESIGN

Prospective cohort study.

SETTING

Pediatric tertiary care referral center in Halifax, Nova Scotia, serving a population of 2.3 million.

PARTICIPANTS

Patients ages 0–18 years with central venous catheters (CVCs) inserted at this facility between 1995 and 2013.

METHODS

Participants were followed from CVC insertion to CLABSI event or until CVC removal. Data were prospectively collected by clinicians, infection prevention and control staff, and nursing staff for the purposes of patient care, surveillance, and quality improvement. Cox proportional hazards regression was used to identify risk factors for CLABSI.

RESULTS

Among 5,648 patients, 385 developed CLABSI (0.74 CLABSI per 1,000 line days; or 3.87 per 1,000 in-hospital line days). Most infections occurred within 60 days of insertion. CLABSI rates decreased from 4.87 per 1,000 in-hospital line days in 1995 to 0.78 per 1,000 in-hospital line days in 2013, corresponding to an 84% reduction. A temporal association of CLABSI reduction with a hand hygiene promotion campaign was identified. CVC type, number of lumens, dressing type, insertion vein, and being in the critical care unit were statistically significantly associated with CLABSI.

CONCLUSIONS

Hospital-wide surveillance over an 18-year period identified children at highest risk for CLABSI and decreasing risk over time; this decrease was temporally associated with a hand hygiene campaign.

Infect Control Hosp Epidemiol 2016;37:939–945

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 37 , Issue 8 , August 2016 , pp. 939 - 945
Copyright
© 2016 by The Society for Healthcare Epidemiology of America. All rights reserved 

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References

1. Dudeck, MA, Weiner, LM, Allen-Bridson, K, et al. National Healthcare Safety Network (NHSN) report, data summary for 2012, device-associated module. Am J Infect Control 2013;41:1148–1166.CrossRefGoogle ScholarPubMed
2. Central Venous Catheter-Associated Blood Stream Infections in Intensive Care Units in Canadian Acute-Care Hospitals: Surveillance Report January 1, 2006 to December 31, 2006 and January 1, 2009 to December 31, 2011. Public Health Agency of Canada website. https://www.ammi.ca/download/cnisp_updates/cnisp_english/CNISP%20CVC-BSI%20Surveillance%20Report%202006,%202009-2011_EN%20FINAL.pdf. Published 2014. Accessed July 10, 2015.Google Scholar
3. Huang, EY, Chen, C, Abdullah, F, et al. Strategies for the prevention of central venous catheter infections: an American Pediatric Surgical Association Outcomes and Clinical Trials Committee systematic review. J Pediatr Surg 2011;46:2000–2011.CrossRefGoogle ScholarPubMed
4. Dudeck, MA, Horan, TC, Peterson, KD, et al. National Healthcare Safety Network (NHSN) Report, data summary for 2010, device-associated module. Am J Infect Control 2011;39:798–816.CrossRefGoogle Scholar
5. Edwards, JR, Peterson, KD, Andrus, ML, et al. National Healthcare Safety Network (NHSN) Report, data summary for 2006, issued June 2007. Am J Infect Control 2007;35:290–301.CrossRefGoogle ScholarPubMed
6. O’Grady, NP, Alexander, M, Burns, LA, et al. Guidelines for the prevention of intravascular catheter-related infections. Am J Infect Control 2011;39:S1–S34.CrossRefGoogle ScholarPubMed
7. Garner, J, Jarvis, W, Emori, T, et al. CDC definitions for nosocomial infections, 1988. Am J Infect Control 1988;16:128–140.CrossRefGoogle ScholarPubMed
8. Hosmer, DW, Lemeshow, S. Applied Logistic Regression, Vol. 2. New York: Wiley, 2000.CrossRefGoogle Scholar
9. Raad, II, Hohn, DC, Gilbreath, BJ, et al. Prevention of central venous catheter-related infections by using maximal sterile barrier precautions during insertion. Infect Control Hosp Epidemiol 1994;15:231–238.CrossRefGoogle ScholarPubMed
10. Canada’s Hand Hygiene Challenge. Canadian Patient Safety Institute website. http://www.patientsafetyinstitute.ca/en/About/Programs/HH/Pages/default.aspx. Published 2010. Accessed October 28, 2015.Google Scholar
11. Blot, K, Bergs, J, Vogelaers, D, Blot, S, Vandijck, D. Prevention of central line-associated bloodstream infections through quality improvement interventions: a systematic review and meta-analysis. Clin Infect Dis 2014;59:96–105.CrossRefGoogle ScholarPubMed
12. O’Grady, NP, Alexander, M, Dellinger, EP, et al. Guidelines for the prevention of intravascular catheter-related infections. The Hospital Infection Control Practices Advisory Committee, Center for Disease Control and Prevention, U.S. Pediatrics 2002;110:e51.Google ScholarPubMed
13. Niedner, MF, Huskins, WC, Colantuoni, E, et al. Epidemiology of central line-associated bloodstream infections in the pediatric intensive care unit. Infect Control Hosp Epidemiol 2011;32:1200–1208.CrossRefGoogle ScholarPubMed
14. van der Kooi, TI, Wille, JC, van Benthem, BH. Catheter application, insertion vein and length of ICU stay prior to insertion affect the risk of catheter-related bloodstream infection. J Hosp Infect 2012;80:238–244.CrossRefGoogle ScholarPubMed
15. Hsu, JF, Tsai, MH, Huang, HR, Lien, R, Chu, SM, Huang, CB. Risk factors of catheter-related bloodstream infection with percutaneously inserted central venous catheters in very low birth weight infants: a center’s experience in Taiwan. Pediatr Neonatol 2010;51:336–342.CrossRefGoogle ScholarPubMed
16. Hoang, V, Sills, J, Chandler, M, Busalani, E, Clifton-Koeppel, R, Modanlou, HD. Percutaneously inserted central catheter for total parenteral nutrition in neonates: complications rates related to upper versus lower extremity insertion. Pediatrics 2008;121:e1152–e1159.CrossRefGoogle ScholarPubMed
17. Vegunta, RK, Loethen, P, Wallace, LJ, Albert, VL, Pearl, RH. Differences in the outcome of surgically placed long-term central venous catheters in neonates: neck vs groin placement. J Pediatr Surg 2005;40:47–51.CrossRefGoogle ScholarPubMed
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