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 language | English (US) |
|---|---|
| Pages (from-to) | 1391-1399 |
| Number of pages | 9 |
| Journal | Infection Control and Hospital Epidemiology |
| Volume | 35 |
| Issue number | 11 |
| DOIs | |
| State | Published - Nov 1 2014 |
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ASJC Scopus subject areas
- Microbiology (medical)
- Epidemiology
- Infectious Diseases
Cite this
Central line–associated bloodstream infections in neonates with gastrointestinal conditions : Developing a candidate definition for mucosal barrier injury bloodstream infections. / Pediatric Prevention EpiCenter Consortium.
In: Infection Control and Hospital Epidemiology, Vol. 35, No. 11, 01.11.2014, p. 1391-1399.Research output: Contribution to journal › Article
}
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.
UR - http://www.scopus.com/inward/record.url?scp=84908320246&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84908320246&partnerID=8YFLogxK
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 -