Prevalence of peripheral venous cannula-related colonization and infections in pediatric intensive care unit

Abstract

Background: Intravenous (IV) access exposes patients to risk of catheter-related infections. The source of infection is either microbial colonization of the cannula or contamination of the hub or drugs. The study objectives were to estimate the prevalence of the peripheral venous cannula (PVC)-related infection and the factors associated with colonization and the antibiotic sensitivity pattern of the organisms causing infection. Subjects and Methods: It was a cross-sectional study which included infants and children who required an indwelling PVC. Visual infusion phlebitis (VIP) score was recorded for insertion site changes. Cannula tip and blood were sent for culture and antibiotic sensitivity. Catheter-related bloodstream infection was diagnosed based on bacterial growth in both the cannula tip and blood culture. Results: Out of the 256 children recruited in the study, 57% were males and 13% were undernourished. The most common primary illness was respiratory disease. Cannula tip growth was noted in 8.5%. The PVC colonization rate was 37.9/1000 catheter days. Multivariate analysis showed significant association between the primary illness, multiple attempts for insertion, longer duration of IV fluid use, retention of cannula beyond 96 h, and higher VIP scores >2 and cannula colonization. Conclusions: Apart from strict adherence to infection prevention techniques, disposal of cannula after one failed attempt, changing IV cannula after 96 h, inspection of cannula site to identify phlebitis early, and removal of the cannula when the VIP score is >2 may help to minimize cannula-related colonization and infection.