First name
Gail
Last name
Potter-Bynoe

Title

Central line-associated bloodstream infections in neonates with gastrointestinal conditions: developing a candidate definition for mucosal barrier injury bloodstream infections.

Year of Publication

2014

Number of Pages

1391-9

Date Published

2014 Nov

ISSN Number

1559-6834

Abstract

<p><strong>OBJECTIVE: </strong>To develop a candidate definition for central line-associated bloodstream infection (CLABSI) in neonates with presumed mucosal barrier injury due to gastrointestinal (MBI-GI) conditions and to evaluate epidemiology and microbiology of MBI-GI CLABSI in infants.</p>

<p><strong>DESIGN: </strong>Multicenter retrospective cohort study.</p>

<p><strong>SETTING: </strong>Neonatal intensive care units from 14 US children's hospitals and pediatric facilities.</p>

<p><strong>METHODS: </strong>A multidisciplinary focus group developed a candidate MBI-GI CLABSI definition based on presence of an MBI-GI condition, parenteral nutrition (PN) exposure, and an eligible enteric organism. CLABSI surveillance data from participating hospitals were supplemented by chart review to identify MBI-GI conditions and PN exposure.</p>

<p><strong>RESULTS: </strong>During 2009-2012, 410 CLABSIs occurred in 376 infants. MBI-GI conditions and PN exposure occurred in 149 (40%) and 324 (86%) of these 376 neonates, respectively. The distribution of pathogens was similar among neonates with versus without MBI-GI conditions and PN exposure. Fifty-nine (16%) of the 376 initial CLABSI episodes met the candidate MBI-GI CLABSI definition. Subsequent versus initial CLABSIs were more likely to be caused by an enteric organism (22 of 34 [65%] vs 151 of 376 [40%]; P = .009) and to meet the candidate MBI-GI CLABSI definition (19 of 34 [56%] vs 59 of 376 [16%]; P &lt; .01).</p>

<p><strong>CONCLUSIONS: </strong>While MBI-GI conditions and PN exposure were common, only 16% of initial CLABSIs met the candidate definition of MBI-GI CLABSI. The high proportion of MBI-GI CLABSIs among subsequent infections suggests that infants with MBI-GI CLABSI should be a population targeted for further surveillance and interventional research.</p>

DOI

10.1086/678410

Alternate Title

Infect Control Hosp Epidemiol

PMID

25333434

Title

Beyond the bundle: a survey of central line-associated bloodstream infection prevention practices used in US and Canadian pediatric hospitals.

Year of Publication

2013

Number of Pages

1208-10

Date Published

2013 Nov

ISSN Number

1559-6834

Abstract

<p>We surveyed US and Canadian pediatric hospitals about their use of central line-associated bloodstream infection (CLABSI) prevention strategies beyond typical insertion and maintenance bundles. We found wide variation in supplemental strategies across hospitals and in their penetration within hospitals. Future studies should assess specific adjunctive prevention strategies and CLABSI rates.</p>

DOI

10.1086/673447

Alternate Title

Infect Control Hosp Epidemiol

PMID

24113607

WATCH THIS PAGE

Subscription is not available for this page.