Central line–associated bloodstream infections in neonates with gastrointestinal conditions: Developing a candidate definition for mucosal barrier injury bloodstream infections

Pediatric Prevention EpiCenter Consortium

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

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: Multi center 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.

Original languageEnglish (US)
Pages (from-to)1391-1399
Number of pages9
JournalInfection Control and Hospital Epidemiology
Volume35
Issue number11
DOIs
StatePublished - Nov 1 2014

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Newborn Infant
Wounds and Injuries
Infection
Parenteral Nutrition
Pediatric Hospitals
Neonatal Intensive Care Units
Microbiology
Focus Groups
Epidemiology
Cohort Studies
Retrospective Studies
Research

ASJC Scopus subject areas

  • Microbiology (medical)
  • Epidemiology
  • Infectious Diseases

Cite this

@article{92a1256c138148f48659d2fd336b2f95,
title = "Central line–associated bloodstream infections in neonates with gastrointestinal conditions: Developing a candidate definition for mucosal barrier injury bloodstream infections",
abstract = "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: Multi center 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.",
author = "{Pediatric Prevention EpiCenter Consortium} and Coffin, {Susan E.} and Klieger, {Sarah B.} and Christopher Duggan and Huskins, {W Charles} and Milstone, {Aaron M.} and Gail Potter-Bynoe and Bram Raphael and Sandora, {Thomas J.} and Xiaoyan Song and Zerr, {Danielle M.} and Lee, {Grace M.} and Kris Bryant and Elaine Cox and Audra Deveikis and David Michalik and Jane Gould and Judith Guzman-Cotrill and Anne Hansen and Galit Holzmann-Pazgal and Larry Kociolek and Latania Logan and Angela Rupp and Edward Septimus and Eileen Sherman and Sarah Wittig",
year = "2014",
month = "11",
day = "1",
doi = "10.1086/678410",
language = "English (US)",
volume = "35",
pages = "1391--1399",
journal = "Infection Control and Hospital Epidemiology",
issn = "0899-823X",
publisher = "University of Chicago Press",
number = "11",

}

TY - JOUR

T1 - Central line–associated bloodstream infections in neonates with gastrointestinal conditions

T2 - Developing a candidate definition for mucosal barrier injury bloodstream infections

AU - Pediatric Prevention EpiCenter Consortium

AU - Coffin, Susan E.

AU - Klieger, Sarah B.

AU - Duggan, Christopher

AU - Huskins, W Charles

AU - Milstone, Aaron M.

AU - Potter-Bynoe, Gail

AU - Raphael, Bram

AU - Sandora, Thomas J.

AU - Song, Xiaoyan

AU - Zerr, Danielle M.

AU - Lee, Grace M.

AU - Bryant, Kris

AU - Cox, Elaine

AU - Deveikis, Audra

AU - Michalik, David

AU - Gould, Jane

AU - Guzman-Cotrill, Judith

AU - Hansen, Anne

AU - Holzmann-Pazgal, Galit

AU - Kociolek, Larry

AU - Logan, Latania

AU - Rupp, Angela

AU - Septimus, Edward

AU - Sherman, Eileen

AU - Wittig, Sarah

PY - 2014/11/1

Y1 - 2014/11/1

N2 - 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: Multi center 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.

AB - 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: Multi center 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.

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U2 - 10.1086/678410

DO - 10.1086/678410

M3 - Article

C2 - 25333434

AN - SCOPUS:84908320246

VL - 35

SP - 1391

EP - 1399

JO - Infection Control and Hospital Epidemiology

JF - Infection Control and Hospital Epidemiology

SN - 0899-823X

IS - 11

ER -