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. 2024 Jan 31;4(1):e16.
doi: 10.1017/ash.2023.534. eCollection 2024.

Is central line type an independent risk factor of central line-associated bloodstream infection in a neonatal intensive care unit population? Experiences at a pediatric hospital in South Texas

Danielle J Durant  1   2 , Nancy Fallwell  3 , Lesley Martinez  3 , Claudia Guerrazzi-Young  4
Affiliations

Is central line type an independent risk factor of central line-associated bloodstream infection in a neonatal intensive care unit population? Experiences at a pediatric hospital in South Texas

Danielle J Durant et al. Antimicrob Steward Healthc Epidemiol. .

Abstract

Background: Central line-associated bloodstream infection (CLABSI) causes significant harm in neonatal intensive care unit (NICU) patients. However, data regarding risk factors and prevention strategies for CLABSI in NICU patients is limited.

Objective: To examine risk factors for CLABSI in a NICU population, with particular interest in central line type and site placement.

Design: Retrospective case-control study.

Setting: NICU (Level IV, 67 bed) at a pediatric hospital in South Texas.

Participants: All central line insertions and subsequent CLABSI cases were extracted from the EHR for NICU admissions occurring from January 1, 2018, to November 3, 2022 (N = 1,356), along with potential CLABSI risk factors.

Methods: Central line insertions resulting in CLABSI (N = 35) were compared to instances without CLABSI (N = 1,321) using bivariate and multivariate analysis, with propensity score matching.

Results: Multivariate risk factors include implantable device (odds ratio [OR] = 14.5, P < .001), neck site placement (OR = 7.2, P < .001), and device dwell time (OR = 5.6, P = .001), as well as years 2021 (OR = 5.1, P = .017) and 2022 (OR = 5.9, P = .011). This indicates the odds of contracting CLABSI are 14.5 times higher when an implantable central line is used compared to the reference category (PICC devices). When cases are paired with matched controls, likelihood of CLABSI is 7.1% higher in patients with an implantable device than in similar patients with other central lines (p = 0.034).

Conclusions: Implantable central lines are an independent risk factor for CLABSI in NICU patients at this facility.

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Conflict of interest statement

NF and LM are current employees of Driscoll Children’s Hospital in the Infection Prevention and Control Department. DJD and CGY have no conflict of interest relevant to this article to disclose.

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