CATHETER RELATED BLOOD STREAM INFECTION IN A TERTIARY NEONATAL INTENSIVE CARE UNIT IN CAIRO; A PROSPECTIVE OBSERVATIONAL STUDY | ||||
| Al-Azhar Journal of Pediatrics | ||||
| Article 6, Volume 25, Issue 2, April 2022, Page 2729-2744 PDF (192.84 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/azjp.2022.259320 | ||||
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| Abstract | ||||
| Background: Although the use of central lines is mandatory in neonatal intensive care units (NICUs), it has multiple complications. Central line associated blood stream infection (CLABSI) is one of the major risk factors to blood stream infection, mortality, and prolonged hospital stay in neonatal population. While care bundles focus on lowering infection rate, quality improvement studies aim to minimize the use of central line. Aim of the work: To evaluate the incidence of catheter related blood stream infection (CLABSI) in babies admitted to NICU of Children Hospital of Ain Shams University over a 6-month period (from 6/2021-12/2021). Subjects and Methods: In this prospective observational study, all neonates who had their first central line inserted during the study period were enrolled regardless of their gestational age or diagnosis. Patients who had early onset neonatal sepsis or had their line removed within 48 hours were excluded. Data of line insertion was collected (e.g., cause of insertion, type of line, time of insertion), and line viability was checked daily (e.g., duration, line culture) till removal of the line or death of the baby. Results: Data from 44 lines (5 Peripherally inserted central catheter PICCs, 18 umbilical catheters, 21 central venous catheters) was analyzed. The most common indication for central line insertion was critical condition (e.g., sever sepsis, post-operative). No statistical correlation between type of line and patient outcome, positive line culture, and central line duration (p>0.05). CLABSI rate was 55.5/1000 central line days. 75% of cultured lines were positive and 34 babies (77.2%) had at least one positive culture proven infection (central line or blood). Positive blood culture (not line culture) was significantly corelated to mortality (p=0.012& p=1.00). Klebsiella was the most identified organism either in the central line (10 cases) or in blood (13 cases). klebsiella in blood (not central line) was significantly correlated to increased mortality compared to other organisms (p=0.027, p=0.108 respectively). Conclusion: Our data suggest that positive blood culture particularly with Klebsiella might correlate with poorer outcome. While central line related infection rate was very high (75%), this might not alone correlate to mortality. Further controlled trials are recommended to estimate the exact impact of central line presence on neonatal outcome and length of stay | ||||
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