Central Line Associated Bloodstream Infection in Neonatal Intensive Care Unit

Abstract

Background Central-line–associated bloodstream infections (CLABSIs) are a major source of healthcare-associated infections in neonatal intensive care units (NICUs), and they are associated with increased morbidity, mortality. Aim To describe the epidemiology, demographic and, etiological characteristics of CLABSI at NICUs of Ain Shams University Hospitals. Patients and Methods Prospective observational study included 136 neonates with central venous catheters (CVCs) over period of 9 months, two blood cultures samples were taken from each patient thought to be infected based on clinical signs suggestive of infection (apnea, bradycardia, bad perfusion, temperature instability) and laboratory markers like Creactive protein (CRP) with one culture sample from CVC and the other from a peripheral vein, CLABSI was diagnosed according to Centers for Disease Control and Prevention (CDC) criteria. Results Twenty-three episodes of CLABSI were reported with a rate of 20.8 per 1000 catheter days. The mean gestational age and mean weight of CLABSI cases were 33.57±2.83 weeks and 1.97 ± 0.71 kg respectively. No statistically significant differences between CLABSI cases and others with no CLABSI as regards demographic characteristics. The use of invasive respiratory support was significantly associated with a high rate of CLABSI episodes. CLABSI was significantly associated with prolonged hospitalization with a mean of 18.78±9.10 days. Klebsiella was the most common isolated organism among CLABSI cases with a percentage of 52.1 %. The percentage of mortality was 56.5% among CLABSI cases Conclusions Evaluation of infection prevention programs is required to determine if specific strategies can be implemented to further reduce infection risk.