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Risk of catheter-associated bloodstream infection by catheter type in a neonatal intensive care unit: a large cohort study of more than 1100 intravascular catheters

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Title: Risk of catheter-associated bloodstream infection by catheter type in a neonatal intensive care unit: a large cohort study of more than 1100 intravascular catheters
Authors: Catho, Gaud, Rosa Mangeret, Flavia, Sauvan, Valérie, Chraiti, Marie-Noëlle, Pfister, Riccardo, Baud, Olivier, Harbarth, Stéphan Juergen, Buetti, Niccolo
Source: Journal of Hospital Infection. 139:6-10
Publisher Information: Elsevier BV, 2023.
Publication Year: 2023
Subject Terms: NICU, Catheterization, Central Venous, Bloodstream infection, Intravascular catheter, CLABSI, Cohort Studies, Central Venous Catheters / adverse effects, Catheters, Indwelling, Risk Factors, Intensive Care Units, Neonatal, Sepsis, Humans, Central Venous Catheters, Retrospective Studies, Infant, Newborn, Catheter-Related Infections / complications, Catheters, Indwelling / adverse effects, Newborn, CABSI, Sepsis / epidemiology, 3. Good health, Catheterization, Central Venous / adverse effects, Catheter-Related Infections / epidemiology, Catheter-Related Infections
Description: The aim of this study was to evaluate the risk of catheter-associated bloodstream infection (CABSI) among different catheter types using a large prospective database in the neonatal intensive care unit (NICU) of a tertiary care centre in Switzerland.We included all neonates admitted to the NICU with at least one central intravascular catheter inserted between January 2017 and December 2020. We used marginal Cox model to determine the risk of CABSI among different catheter types.A total of 574 neonates and 1103 intravascular catheters were included in the study: 581 venous umbilical catheters, 198 arterial umbilical catheters and 324 peripherally inserted central catheters (PICCs). We identified 17, four and four CABSIs in neonates with venous umbilical catheters, arterial umbilical catheters and PICCs, respectively. The risk of CABSI increased after two days of umbilical catheter maintenance. Using univariable Cox models, and adjusting for sex and gestational age, we observed a similar CABSI risk between venous and arterial umbilical catheters (HR 0.57; 95% CI 0.16e2.08). Birth weight was associated with CABSI, with higher weight being protective (HR 0.37, 95% CI 0.16e0.81).Strategies aimed at reducing umbilical catheter dwell time, particularly in low and very low birth weight neonates, may be effective in decreasing the incidence of CABSI in this population.
Document Type: Article
File Description: application/pdf
Language: English
ISSN: 0195-6701
DOI: 10.1016/j.jhin.2023.06.011
Access URL: https://pubmed.ncbi.nlm.nih.gov/37343772
Rights: CC BY
Accession Number: edsair.doi.dedup.....30326d56b8d245348b1da49b39f080e3
Database: OpenAIRE
Description
Abstract:The aim of this study was to evaluate the risk of catheter-associated bloodstream infection (CABSI) among different catheter types using a large prospective database in the neonatal intensive care unit (NICU) of a tertiary care centre in Switzerland.We included all neonates admitted to the NICU with at least one central intravascular catheter inserted between January 2017 and December 2020. We used marginal Cox model to determine the risk of CABSI among different catheter types.A total of 574 neonates and 1103 intravascular catheters were included in the study: 581 venous umbilical catheters, 198 arterial umbilical catheters and 324 peripherally inserted central catheters (PICCs). We identified 17, four and four CABSIs in neonates with venous umbilical catheters, arterial umbilical catheters and PICCs, respectively. The risk of CABSI increased after two days of umbilical catheter maintenance. Using univariable Cox models, and adjusting for sex and gestational age, we observed a similar CABSI risk between venous and arterial umbilical catheters (HR 0.57; 95% CI 0.16e2.08). Birth weight was associated with CABSI, with higher weight being protective (HR 0.37, 95% CI 0.16e0.81).Strategies aimed at reducing umbilical catheter dwell time, particularly in low and very low birth weight neonates, may be effective in decreasing the incidence of CABSI in this population.
ISSN:01956701
DOI:10.1016/j.jhin.2023.06.011