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Table 1 The main features of currently used surveillance criteria of neonatal CLABSI summarised

From: Sustainable neonatal CLABSI surveillance: consensus towards new criteria in the Netherlands

  CDC NEO-KISS Dutch neonatal CLABSI criteria
Target patient population ≤ 1 year Very low birthweight infants: birthweight < 1500 g Neonates: postnatal age ≤ 28 days for term and up to postmenstrual age of 44 weeks for preterm infants
Description of CLABSI criteria Laboratory-confirmed bloodstream infection
(1) with a detected pathogen
OR
(2) with the same common commensala confirmed by a second blood specimen
Laboratory-confirmed bloodstream infection
(1) with a detected pathogen
OR
(2) with CoNS confirmed by a second blood specimen or one out of 4 laboratory elements
Laboratory-confirmed bloodstream infection
(1) with a detected pathogen
OR
(2) with same common commensala confirmed by a second blood specimen
OR
(3) with a common commensal and CRP > 10 mg/L
Clinical sepsis
(3) no detected pathogen
Clinical findings used in criteria One out of fourb clinical symptoms for CoNS CLABSI criteria Two or more out of 16c
findings bundled in seven categories for all CLABSI criteria
Clinical symptoms of neonatal sepsis according to the treating physician for “common commensal CLABSI criteria”
Challenges for application in the Dutch setting Two blood cultures for one event (not common practice, single blood culture policy) Numerous clinical elements (labour intensive surveillance and possible interference with interrater agreement)
  1. CDC, Centers for Disease Control; CLABSI, central line-associated bloodstream infections; CoNS, Coagulase-negative Staphylococci species; CRP, C-reactive protein; NEO-KISS, NEO-Krankenhaus Infektions Surveillance System
  2. aAccording to the NHSN Master Organism List
  3. bCDC clinical findings: fever (> 38 °C), hypothermia (< 36.5 °C), apnoea, or bradycardia
  4. cNEO-KISS clinical findings: (1) fever (> 38 °C) or temperature instability or hypothermia (< 36.5 °C); (2) tachycardia (> 200/min) or new increasing bradycardia (< 80/min); 3) capillary refill time > 2 s; (4) new or increasing apnoea (> 20 s); (5) otherwise unexplained metabolic acidosis (BE < − 10 mval/L); (6) new onset of hyperglycaemia (> 140 mg/dL); (7) other sighs of sepsis (skin colour, biochemical signs, increasing oxygen requirement, unstable general status, apathy)