Hussain Ali Shabbir Shabbir, Ali Syed Rehan, Ariff Shabina, Arbab Saba, Demas Simon, Zeb Jehan, Rizvi Arjumand
Department of Pediatrics and Child Health, The Aga Khan University, Karachi, Pakistan.
Department of Pediatrics, The Aga Khan University Hospital, Karachi, Pakistan.
BMJ Paediatr Open. 2017 Nov 1;1(1):e000008. doi: 10.1136/bmjpo-2017-000008. eCollection 2017.
Central line-associated bloodstream infections (CLABSI) are the most important cause of morbidity and mortality in critically ill patients. Evidence-based interventions when used in form of a bundle have proven to decrease CLABSI. Our unit has a high CLABSI rate (9/1000 central line days). Therefore, we intend to introduce evidence-based CLABSI prevention package in our practice to improve CLABSI rates in our NICU within limited resources.
The study will be conducted using preanalysis and postanalysis design from January 2016 to December 2017. It is going to be conducted in three phases with phase I being the preimplimentation phase where retrospective data will be collected. Phase II, implementation phase, where the CLABSI prevention package will be introduced and phase III will be follow-up to see the impact. Primary outcome will be reduction in CLABSI rates.
For all three phases, descriptive analysis will be performed. Nominal data will be presented as mean±SD, whereas categorical data will be presented as frequencies and percentages. To compare the effect of intervention we will use independent sample t-test for continuous outcomes, whereas Χ test will be used for categorical outcomes. Relative risk ratios, 95% CI, and p values will be determined. Incidence density will be calculated and Poisson regression will be used to determine factors associated with incidence of CLABSI. Microbiological profiles and antimicrobial resistance pattern will be reported as pan sensitive, multidrug-resistant organism and carbapenem-resistant organism. SQUIRE V.2.0 guidelines will be used for manuscript writing and reporting.
中心静脉导管相关血流感染（CLABSI）是重症患者发病和死亡的最重要原因。以集束化形式使用的循证干预措施已被证明可降低CLABSI。我们科室的CLABSI发生率较高（每1000个中心静脉导管日发生9例）。因此，我们打算在实际工作中引入循证CLABSI预防方案，以便在有限资源的情况下提高我们新生儿重症监护病房（NICU）的CLABSI发生率。
本研究将采用2016年1月至2017年12月的预分析和后分析设计。研究将分三个阶段进行，第一阶段为实施前阶段，将收集回顾性数据。第二阶段为实施阶段，将引入CLABSI预防方案，第三阶段为随访阶段，以观察其影响。主要结局将是CLABSI发生率的降低。
对于所有三个阶段，将进行描述性分析。计量资料将以均数±标准差表示，而分类资料将以频数和百分比表示。为比较干预效果，对于连续性结局我们将使用独立样本t检验，而对于分类结局将使用χ检验。将确定相对危险度、95%可信区间和p值。将计算发病密度，并使用泊松回归确定与CLABSI发生率相关的因素。微生物学特征和抗菌药物耐药模式将报告为泛敏感、多重耐药菌和耐碳青霉烯类菌。将使用SQUIRE V.2.0指南撰写和报告论文。
