Document Detail

Incidence of Catheter-Related Bloodstream Infections in Neonates Following Removal of Peripherally Inserted Central Venous Catheters.
MedLine Citation:
PMID:  24141656     Owner:  NLM     Status:  Publisher    
OBJECTIVES:: Catheter-associated bloodstream infections are a significant source of morbidity and healthcare cost in the neonatal ICU. Previous studies examining the prevalence of bloodstream infections after removal of peripherally inserted central venous catheters in neonates are equivocal.
DESIGN:: A retrospective cohort study. Patients: All infants with peripherally inserted central venous catheters treated at the Vanderbilt neonatal ICU between 2007 and 2009.
MEASUREMENTS AND MAIN RESULTS:: We evaluated the following outcomes: 1) bloodstream infections, 2) culture-negative sepsis, 3) number of sepsis evaluations, and 4) number of significant apnea/bradycardia events comparing odds ratios between 72 hours before and 72 hours after peripherally inserted central venous catheter removal. We analyzed a total of 1,002 peripherally inserted central venous catheters in 856 individual infants with a median (interquartile range) gestational age of 31 weeks (28-37 wk) and a median birth weight of 1,469 g (960-2,690 g). Comparing 72 hours before with 72 hours after peripherally inserted central venous catheter removal did not show a difference in the prevalence of bloodstream infections (9 vs 3, p = 0.08), prevalence of culture-negative sepsis (37 vs 40, p = 0.73), number of sepsis evaluations (p = 0.42), or number of apnea/bradycardia events (p = 0.32). However, in peripherally inserted central venous catheter not used for delivery of antibiotics, there was a 3.83-fold increase in odds for culture-negative sepsis following peripherally inserted central venous catheter removal (95% confidence interval, 1.48-10.5; p = 0.001). For infants less than 1,500 g birth weight (very low birth weight), odds for culture-negative sepsis increased to 6.3-fold following removal of peripherally inserted central venous catheters not used for antibiotic delivery (95% confidence interval, 1.78-26.86; p < 0.01).
CONCLUSIONS:: Although these data do not support the routine use of antibiotics for sepsis prophylaxis prior to peripherally inserted central venous catheter removal, they suggests that very low birth weight infants not recently exposed to antibiotics are at increased odds for associated adverse events following discontinuation of their peripherally inserted central venous catheter.
Michael Casner; Sandra J Hoesli; James C Slaughter; Melissa Hill; Jörn-Hendrik Weitkamp
Related Documents :
22984646 - Maternal body composition and its relationship to infant breast milk intake in rural pa...
22946146 - Infant feeding and obesity risk in the child.
8431326 - Extra inspiratory work of breathing imposed by cricothyrotomy devices.
24502196 - Factors contributing to infant overfeeding with hispanic mothers.
2317456 - Alloimmunization to the pla1 platelet antigen: results of a prospective study.
10910546 - Intractable wheezing and swallowing problem in an infant: report of one case.
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-10-17
Journal Detail:
Title:  Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies     Volume:  -     ISSN:  1529-7535     ISO Abbreviation:  Pediatr Crit Care Med     Publication Date:  2013 Oct 
Date Detail:
Created Date:  2013-10-21     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100954653     Medline TA:  Pediatr Crit Care Med     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
1Vanderbilt University School of Medicine, Nashville, TN. 2Department of Pediatrics, Monroe Carell Jr Children's Hospital at Vanderbilt, Vanderbilt University, Nashville, TN. 3Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Previous Document:  Vasopressin as a Rescue Therapy for Refractory Pulmonary Hypertension in Neonates: Case Series.
Next Document:  Impact of the Shift to Neonatal Noninvasive Ventilation in Poland: A Population Study.