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O062: Contamination of umbilical catheters by Staphylococcus epidermidis in neonatology: is there a link with a change in the standard of care?
Antimicrobial Resistance and Infection Control volume 2, Article number: O62 (2013)
The presence of Staphylococcus epidermidis (SCE) on umbilical venous (UVC) or artery catheters (UAC) suggests defects either in catheter care or in hand hygiene compliance.
The aim of this study was to assess colonization of UVC and UAC with SCE before and after care practice of such catheters was changed.
This observational before-after study was conducted in the neonatology unit of HUG between January 2002 and December 2012. SCE-colonization rates before and after protocol change in August 2011 was compared by chi-square test and Poisson regression model. In the new protocol, UVC and UAC were not covered by a dressing but left at air. All neonates with the following risk factors were eligible: gestational age [GA] <32 weeks, birth weight <1500g, invasive device, surgery, use of parenteral nutrition, systemic antibiotics.
In total, 2832 neonates were analyzed. Mean birth weight (±SD) was 2179g (±970) and 213 neonates had GA < 32 weeks(7.5%). SCE colonization on UVC and UAC was 54/1070 (5.1%) and 16/435 (3.7%), respectively. Colonization on UVC was significantly higher after procedure change in the univariate (53.7/1000 catheter-days versus 9.6/1000; P<0.001) as well as in the multivariate analysis adjusting for GA, birth weight, and multiple pregnancy (IRR [95% CI]: 2.4 [1.4-4.3]; P=0.003). Colonization of UAC was significantly higher after procedure change in the univariate (43.5/1000 cathter-days versus 7.9/1000; P<0.001) as well as in the multivariate analysis (IRR [95%CI]: 5.0 [1.7-15.2]; P=0.004). No association was found for catheter-related bloodstream infection.
Leaving umbilical catheters exposed to air rather than protected by a dressing may result in significant colonization with SCE. Larger studies must confirm our findings and test the hypothesis whether such practice promotes bloodstream infection.
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Soulake, I., Gayet-Ageron, A., Bochaton, N. et al. O062: Contamination of umbilical catheters by Staphylococcus epidermidis in neonatology: is there a link with a change in the standard of care?. Antimicrob Resist Infect Control 2 (Suppl 1), O62 (2013). https://doi.org/10.1186/2047-2994-2-S1-O62
- Birth Weight
- Parenteral Nutrition
- Bloodstream Infection
- Hand Hygiene
- Multiple Pregnancy