BACKGROUNDS. The central vascular catheter associated bloodstream infections are a significant source of morbidity, mortality and increased healthcare costs in critically ill children.
METHODS. This study included all 461 children who were admitted to the pediatric intensive care unit of Department of pediatric surgery and intensive care of University medical center Ljubljana in year 2011. Patients were classified into medical and surgical group. Data on patients days, CVC days and CVC-associated bloodstream infections were collected daily according to the methodology of the Centers for Disease Control and Prevention from Atlanta. Based on these data, we calculated monthly and annual number of patient days, CVC days, central vascular catheter utilization ratio, utilization ratios for subgroups of central vascular catheters and rate of CVC-associated bloodstream infections per 1,000 CVC days. All these data were separately analyzed for medical and surgical patients.
RESULTS. A total of 3,589 patient days and 2,647 central line days were recorded during the study period. There were 13 episodes of CVC-associated bloodstream infections; 11 in the surgical group (6 after cardiac surgery, 5 after abdominal surgery) and 2 in the medical group. Rate of CVC-associated bloodstream infections was 1.99 infections per 1,000 CVC days in medical group and 6.69 infections per 1,000 CVC days in surgical group. Use of central vascular catheters for dialysis (18.18 infections per 1,000 CVC days) and simultaneous use of ≥ 2 central vascular catheters (19.42 infections per 1,000 CVC days) were associated with highest rates of CVC-associated bloodstream infections in surgical group. A correlation was found between monthly number of CVC-associated bloodstream infections and monthly number of patient days in pediatric intensive care unit.
CONCLUSIONS. Rate of CVC-associated bloodstream infections is significantly higher in surgical compared to medical patients in pediatric intensive care unit. Cardiac surgery, abdominal surgery, use of dialysis central vascular catheters and presence of ≥ 2 central vascular catheters are important risk factors for CVC-associated bloodstream infections in surgical patients. Rate of CVC-associated bloodstream infections in pediatric intensive care unit is correlated with number of patient days (Spearman’s correlation coefficient = 0.674, p = 0.016).