Sellamuthu Ravina, Nair Sajitha, Chandrasekar Jayakumar, Kesavan Sajith, Shivam Vishnu
Pediatrics, Amrita Institute of Medical Sciences and Research Centre, Kochi, IND.
Research and Development, Vedanadhi, Salem, IND.
Cureus. 2023 Aug 11;15(8):e43349. doi: 10.7759/cureus.43349. eCollection 2023 Aug.
Background Central line-associated bloodstream infection (CLABSI) is the most common hospital-acquired infection. However, studies evaluating the factors associated with the risk of CLABSI in pediatric intensive care units (PICU) were limited in India. Objective The objective of our study is to evaluate the association of factors and the etiology causing CLABSI. Study design This is a hospital-based single-center prospective study conducted in the pediatric intensive care unit (PICU) of our tertiary care hospital spanning one year. Participants Children aged between two months to 15 years admitted in the PICU for more than 48 hours with central venous catheterization were included. Pearson's chi-squared test with Yates' continuity correction and logistic regression with odds ratio were calculated by R statistical software (R Foundation for Statistical Computing, Vienna, Austria) and a p-value less than 0.05 was considered statistically significant. Results Our analysis showed that factors such as young age (2-12 months), high pediatric risk of mortality (PRISM III) score (> 15), leukocytosis, neutrophilia, anemia, change of central venous catheter, duration of catheterization (>7 days), exposure to blood products, use of steroids, inotropes, and prophylactic antibiotics were significantly associated with increased risk of CLABSIs with an odds ratio of 4.53, 4.54, 2.91, 4.56, 4.76, 3.74, 2.49, 2.41, 7.22, 6.77 and 5.16 respectively (p<0.05). Further, factors such as older age (>12 months) and low PRISM III score (≤ 15) significantly reduce the risk of CLABSIs by 83.64% and 69.14% respectively (p<0.05). Conclusion In conclusion, our results revealed that factors such as young age, high PRISM III score, leukocytosis, neutrophilia, anemia, change of central venous catheter, duration of catheterization (> 7 days), exposure to blood products during the hospital stay, use of steroids, inotropes, and prophylactic antibiotics were identified as risk factors for CLABSI.
背景 中心静脉导管相关血流感染（CLABSI）是最常见的医院获得性感染。然而，在印度，评估儿科重症监护病房（PICU）中与CLABSI风险相关因素的研究有限。目的 我们研究的目的是评估导致CLABSI的因素与病因之间的关联。研究设计 这是一项在我们三级护理医院的儿科重症监护病房（PICU）进行的基于医院的单中心前瞻性研究，为期一年。参与者 纳入在PICU住院超过48小时且接受中心静脉置管的2个月至15岁儿童。使用R统计软件（奥地利维也纳的R统计计算基金会）计算经Yates连续性校正的Pearson卡方检验和比值比的逻辑回归，p值小于0.05被认为具有统计学意义。结果 我们的分析表明，年龄较小（2至12个月）、儿科死亡风险（PRISM III）评分较高（>15）、白细胞增多、中性粒细胞增多、贫血、中心静脉导管更换、置管时间（>7天）、接触血液制品、使用类固醇、血管活性药物和预防性抗生素等因素与CLABSI风险增加显著相关，比值比分别为4.53、4.54、2.91、4.56、4.76、3.74、2.49、2.41、7.22、6.77和5.16（p<0.05）。此外，年龄较大（>12个月）和PRISM III评分较低（≤15）的因素分别显著降低CLABSI风险达83.64%和69.14%（p<0.05）。结论 总之，我们的结果显示，年龄较小、PRISM III评分较高、白细胞增多、中性粒细胞增多、贫血、中心静脉导管更换、置管时间（>7天）、住院期间接触血液制品、使用类固醇和预防性抗生素等因素被确定为CLABSI的危险因素。
