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Central venous catheter-related nosocomial bloodstream infections in children on long-term parenteral nutrition : the impact of the move to a new university hospital.
© Valdeyron et al; licensee BioMed Central Ltd. 2015
Published: 16 June 2015
Insufficient training in CVC management contributes in the development of CRBSIs
This study evaluated the impact of moving to a new university paediatric hospital on the incidence of central catheter-related blood stream infections (CRBSIs) among children on long-term parenteral nutrition.
This retrospective study covered from April 2007 to March 2014, starting a year prior to move the children to a new hospital in April 2008, and continuing for 6 years following the move. During this observational period, data from all children hospitalized in a hepato-gastroenterology and nutrition unit of a paediatric tertiary hospital who received parenteral nutrition (PN) for more than 15 days were analysed.
During this 7-year study, 183 children aged 4.6 ± 0.5 years received prolonged PN. Intestinal diseases were the main aetiologies (89%), primarily short bowel syndrome (18.4%), Hirschsprung disease and Chronic Intestinal Pseudo-Obstruction syndrome (CIPO) (13.5%) and inflammatory bowel disease (13.8%). The mean durations of hospitalization and of PN during hospital stay were, respectively, 70±2.1 and 55.7±3.6 days. During the study period, 151 CRBSIs occurred in 77 children (the attack rate was 42% of all patients), i.e. 14.8 septic episodes per1000 PN-days and 12.0 septic episodes per1000 CVC-days. No patient died of a central venous catheter-related infection.
However, following the move from the older hospital to the newer one, the rate of CRBSIs significantly doubled, from 3.9 to 8.8 per 1000 CVC-days (p=0.02). During the following 4 years, the incidence of CRBSIs tended to increase between the 2nd and the 5th year after the move: 11.3 (p=0.5); 21.4 (p=0.01); 17.3 (p=0.4), 20.3 per 1000 (p=0.6) CVC-days. After evaluations by the Department of Infection Control, nurse training and stabilization of the nursing team, the incidence decreased significantly from 20.3 to 11.1/1000 CVC-days during the 6th year after the move (p=0.01).
Our results revealed the deleterious impact of the hospital move on the CRBSI incidence rate in hospitalized children on PN, and the necessity in having a trained, experienced and stable team of nurses to prevent nosocomial infections.
Disclosure of interest
This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.