Percutaneously placed central venous catheter-related sepsis in Canadian neonatal intensive care units

Abstract

Objectives: To estimate daily risk, variability between centers, and impact on outcomes of catheter-related sepsis (CRS) among preterm neonates.

Study design: Retrospective evaluation of data from centers in the Canadian Neonatal Network for neonates born at <29 weeks or <1000 g who had a percutaneously placed central venous catheter (PCVC) in place for ≥ 48 hours.

Results: Of 2966 infants with a PCVC, 582 (19.6%) developed CRS (overall rate 11/1000 catheter days). The daily risk of CRS varied between 1% and 2% in the first 28 days, and rates of CRS varied between centers (0 to 37 infections/1000 catheter days). Birth weight and gestational age were lower, and Score for Neonatal Acute Physiology and day of life of insertion were higher among those with CRS. Average length of stay was 6.2 days longer for those with CRS. There was no difference in mortality or major morbidities between infants who had CRS and those without CRS.

Conclusions: No threshold length of catheter usage days within the first 28 days was identified at or after which the risk of CRS increased. Marked variability between centers was present. Patients with CRS had an increased length of stay, but no increased risk for mortality or major morbidities.