Is central line type an independent risk factor of central line-associated bloodstream infection in a neonatal intensive care unit population? Experiences at a pediatric hospital in South Texas.

BACKGROUND

Central line-associated bloodstream infection (CLABSI) causes significant harm in neonatal intensive care unit (NICU) patients. However, data regarding risk factors and prevention strategies for CLABSI in NICU patients is limited.

OBJECTIVE

To examine risk factors for CLABSI in a NICU population, with particular interest in central line type and site placement.

DESIGN

Retrospective case-control study.

SETTING

NICU (Level IV, 67 bed) at a pediatric hospital in South Texas.

PARTICIPANTS

All central line insertions and subsequent CLABSI cases were extracted from the EHR for NICU admissions occurring from January 1, 2018, to November 3, 2022 ( = 1,356), along with potential CLABSI risk factors.

METHODS

Central line insertions resulting in CLABSI ( = 35) were compared to instances without CLABSI ( = 1,321) using bivariate and multivariate analysis, with propensity score matching.

RESULTS

Multivariate risk factors include implantable device (odds ratio [OR] = 14.5, < .001), neck site placement (OR = 7.2, < .001), and device dwell time (OR = 5.6, = .001), as well as years 2021 (OR = 5.1, = .017) and 2022 (OR = 5.9, = .011). This indicates the odds of contracting CLABSI are 14.5 times higher when an implantable central line is used compared to the reference category (PICC devices). When cases are paired with matched controls, likelihood of CLABSI is 7.1% higher in patients with an implantable device than in similar patients with other central lines ( = 0.034).

CONCLUSIONS

Implantable central lines are an independent risk factor for CLABSI in NICU patients at this facility.