Aims To differentiate between Central Line Associated Blood Stream Infections (CLABSI) and Catheter Related Blood Stream Infections (CRBSI) where the same microorganism is identified on catheter tip cultures and the bloodstream, in Pediatric Intensive Care Unit (PICU) patients.
Methods Prospective 1 year study of CLABSI (group 1- all patients with a CVC in situ) and CRBSI (group 2-only first, temporary CVC, inserted in PICU, during first admission). CLABSI and CRBSI rates were estimated according standard criteria. CVC insertion and maintenance was under local protocols (simple polyurethane, multiple lumen, plus chlorexidine-gluconate- impregnated sponge, stayed as long as needed if they were functioning without evidence of local or systemic complications).
Results 91 patients have had a total of 136 CVCs insertions. 112 temporary and 24 permanent catheters were evaluated for CLABSI whereas 73 CVCs were evaluated for CRBSI. Mean catheter days in group I was 11.95±12.48 and 20 cases of CLABSI were recorded in 1626 catheter days, given a CLABSI rate of 12.3:1000, whereas mean catheter days in group 2 was 9.30±5.23 with 1 case of CRBSI in 679 catheter days, given a CRBSI rate of 1.47:1000. 11 Gram -, 8 Gram + and 1 fungal infection were recorded in group 1, and only 1 Gram - infection in group 2.
Conclusions Strict adherence to protocols in group 2 led to much lower CRBSI compared to CLABSI. Gram - infections predominated. Reducing CLABSI and CRBSI over time, after implementation of bundles of care, should be the goal.
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