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|Title||Central line-associated bloodstream infections in neonates with gastrointestinal conditions: developing a candidate definition for mucosal barrier injury bloodstream infections.|
|Publication Type||Journal Article|
|Year of Publication||2014|
|Authors||Coffin SE, Klieger SB, Duggan C, W Huskins C, Milstone AM, Potter-Bynoe G, Raphael B, Sandora TJ, Song X, Zerr DM, Lee GM|
|Corporate Authors||Pediatric Prevention EpiCenter Consortium|
|Journal||Infect Control Hosp Epidemiol|
|Date Published||2014 Nov|
OBJECTIVE: To develop a candidate definition for central line-associated bloodstream infection (CLABSI) in neonates with presumed mucosal barrier injury due to gastrointestinal (MBI-GI) conditions and to evaluate epidemiology and microbiology of MBI-GI CLABSI in infants.
DESIGN: Multicenter retrospective cohort study.
SETTING: Neonatal intensive care units from 14 US children's hospitals and pediatric facilities.
METHODS: A multidisciplinary focus group developed a candidate MBI-GI CLABSI definition based on presence of an MBI-GI condition, parenteral nutrition (PN) exposure, and an eligible enteric organism. CLABSI surveillance data from participating hospitals were supplemented by chart review to identify MBI-GI conditions and PN exposure.
RESULTS: During 2009-2012, 410 CLABSIs occurred in 376 infants. MBI-GI conditions and PN exposure occurred in 149 (40%) and 324 (86%) of these 376 neonates, respectively. The distribution of pathogens was similar among neonates with versus without MBI-GI conditions and PN exposure. Fifty-nine (16%) of the 376 initial CLABSI episodes met the candidate MBI-GI CLABSI definition. Subsequent versus initial CLABSIs were more likely to be caused by an enteric organism (22 of 34 [65%] vs 151 of 376 [40%]; P = .009) and to meet the candidate MBI-GI CLABSI definition (19 of 34 [56%] vs 59 of 376 [16%]; P < .01).
CONCLUSIONS: While MBI-GI conditions and PN exposure were common, only 16% of initial CLABSIs met the candidate definition of MBI-GI CLABSI. The high proportion of MBI-GI CLABSIs among subsequent infections suggests that infants with MBI-GI CLABSI should be a population targeted for further surveillance and interventional research.
|Alternate Journal||Infect Control Hosp Epidemiol|
|PubMed Central ID||PMC4551075|
|Grant List||K24 HD058795 / HD / NICHD NIH HHS / United States |
K24HD058795 / HD / NICHD NIH HHS / United States
U54-CK000163 / CK / NCEZID CDC HHS / United States