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. 2021 Feb 5;10(1):31.
doi: 10.1186/s13756-021-00900-3.

Sustainable neonatal CLABSI surveillance: consensus towards new criteria in the Netherlands

I E Heijting  1 , T A J Antonius  2 , A Tostmann  3 , W P de Boode  2 , M Hogeveen  2 , J Hopman  4 ; Working Group on Neonatal Infectious Diseases of the Section of Neonatology of the Dutch Paediatric Society
Collaborators, Affiliations

Sustainable neonatal CLABSI surveillance: consensus towards new criteria in the Netherlands

I E Heijting et al. Antimicrob Resist Infect Control. .

Abstract

Background: Central line-associated bloodstream infections (CLABSI) are a main focus of infection prevention and control initiatives in neonatal care. Standardised surveillance of neonatal CLABSI enables intra- and interfacility comparisons which can contribute to quality improvement. To date, there is no national registration system for CLABSI in neonatal care in the Netherlands and several criteria are used for local monitoring of CLABSI incidence rates. To achieve standardised CLABSI surveillance we conducted a consensus procedure with regard to nationwide neonatal CLABSI surveillance criteria (SC).

Methods: A modified Delphi consensus procedure for the development of nationwide neonatal CLABSI SC was performed between January 2016 and January 2017 in the Netherlands. An expert panel was formed by members of the Working Group on Neonatal Infectious Diseases of the Section of Neonatology of the Dutch Paediatric Society. The consensus procedure consisted of three expert panel rounds.

Results: The expert panel achieved consensus on Dutch neonatal CLABSI SC. Neonatal CLABSI is defined as a bloodstream infection occurring more than 72 h after birth, associated with an indwelling central venous or arterial line and laboratory confirmed by one or more blood cultures. In addition, the blood culture finding should not be related to an infection at another site and one of the following criteria can be applied: 1. a bacterial or fungal pathogen is identified from one or more blood cultures; 2. the patient has clinical symptoms of sepsis and 2A) a common commensal is identified in two separate blood cultures or 2B) a common commensal is identified by one blood culture and C-reactive protein level is above 10 mg/L in the first 36 h following blood culture collection.

Conclusions: The newly developed Dutch neonatal CLABSI SC are concise, specified to the neonatal population and comply with a single blood culture policy in actual neonatal clinical practice. International agreement upon neonatal CLABSI SC is needed to identify best practices for infection prevention and control.

Keywords: Catheter-related infections; Central line-associated bloodstream infections (CLABSI); Cross infection; Epidemiological monitoring; Hospital-acquired infections (HAI); Infection control; Neonatal intensive care unit (NICU); Newborn; Quality improvement; Surveillance.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Detailed description and results of the structured consensus procedure
Fig. 2
Fig. 2
Summary of the Dutch neonatal CLABSI surveillance criteria. *Blood specimens for blood culture can be collected through peripheral venepuncture or can be sampled through central lines and should be obtained in compliance with existing guidelines before the start of antibiotic treatment following hygienic precautions. ¥Common commensals according to NHSN Master Organism List include, but are not limited to, Coagulase-negative Staphylococci (CoNS). §Confirmation by a second blood specimen means two or more blood specimens are sampled on separate occasions. These separate occasions are defined as at least two separate blood samples collected on the same or consecutive calendar days
See this image and copyright information in PMC

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