National Reference Center for the Surveillance of Nosocomial Infections, Institute for Hygiene and Environmental Medicine, Charité-University Medicine Berlin, Berlin, Germany.
Infect Control Hosp Epidemiol. 2010 Apr;31(4):395-401. doi: 10.1086/651303.
To describe the relationship between the use of central and peripheral venous catheters and the risk of nosocomial, primary, laboratory-confirmed bloodstream infection (BSI) for neonates with a birth weight less than 1,500 g (very-low-birth-weight [VLBW] infants).
Cox proportional hazard regression analysis with time-dependent variable was used to determine the risk factors for the occurrence of BSI in a cohort of VLBW infants. We analyzed previously collected surveillance data from the German national nosocomial surveillance system for VLBW infants. All VLBW infants in 22 participating neonatal departments who had a complete daily record of patient information were included.
Of 2,126 VLBW infants, 261 (12.3%) developed a BSI. The incidence density for BSI was 3.3 per 1,000 patient-days. The multivariate analysis identified the following significant independent risk factors for BSI: lower birth weight (hazard ratio [HR], 1.1-2.2), vaginal delivery (HR, 1.5), central venous catheter use (HR, 6.2) or peripheral venous catheter use (HR, 6.0) within 2 days before developing BSI, and the individual departments (HR, 0.0-4.6).
After adjusting for other risk factors, use of peripheral venous catheter and use of central venous catheter were significantly related to occurrence of BSI in VLBW infants.
描述出生体重＜1500g（极低出生体重儿）新生儿使用中心静脉导管和外周静脉导管与医院获得性、原发性、实验室确诊血流感染（BSI）风险之间的关系。
采用时依变量 Cox 比例风险回归分析，确定极低出生体重儿队列中 BSI 发生的危险因素。我们分析了来自德国全国医院获得性监测系统针对极低出生体重儿的前瞻性监测数据。所有纳入 22 个参与新生儿科、且具有完整的患者信息日记录的极低出生体重儿均被纳入研究。
在 2126 例极低出生体重儿中，有 261 例（12.3%）发生 BSI。BSI 的发病率密度为 3.3/1000 患者日。多变量分析确定了以下与 BSI 发生显著相关的独立危险因素：较低的出生体重（风险比[HR]，1.1-2.2）、阴道分娩（HR，1.5）、BSI 发生前 2 天内使用中心静脉导管（HR，6.2）或外周静脉导管（HR，6.0），以及各科室（HR，0.0-4.6）。
在调整其他危险因素后，外周静脉导管和中心静脉导管的使用与极低出生体重儿 BSI 的发生显著相关。
