2. Central line associated blood stream infection in a pediatric cardiac intensive care unit: Incidence, risk factors, and outcome

Abstract

Clinical research. Oral presentation. Central Line Associated Blood Stream Infection (CLABSI) is a serious infection associated with 28,000 deaths and expenses from $296 million to $2.3 billion yearly. There is scarcity of data on CLABSI in pediatric cardiac intensive care units (PCICU). The aim of the study is to describe the risk factors, causative organisms and outcome of CLABSI in a PCICU. The study was retrospective cohort in which all charts of patients admitted to the PCICU from January 2012 to September 2012 were reviewed. Patients who had central line were followed to see if they develop CLABSI from the central line insertion date until discharge. Two hundred and sixty-one patients were included in the study. There were 2275 central line days and 19 CLABSI episodes (8.35 CLABSIs per 1000 central line days). Most common causative pathogens isolated were gram negative bacteria (N = 10, 50%) with Klebsiella pneumoniae and coagulase negative Staphylococcus were the leading causative organisms (N = 4, 20% each). Patients who developed the infection had a longer stay at the PCICU with a mean of 27.1 days compared to 8.20 days for non CLABSI Patients (P < 0.0001). The death rate associated with CLABSI was 10.5% compared with 1.2% in non CLABSI patients (P = 0.004). Multiple logistic regression analysis showed TPN, systemic corticosteroids and Mechanical ventilator utilization >7 days were independent risk factors. CLABSI increased the length of PCICU stay and mortality, yet it has recognizable associated risk factors. Infection control measures should be carefully implemented with special attention given to patients with CLABSI risk factors.