[Risk of infection of central venous catheters in childhood--results of a prospective study].

Contamination rate of 228 central venous catheters and incidence of catheter related septicaemia were studied prospectively in 133 children (98 newborn, 11 infants, 14 children). An exact protocol determined all details related to catheter insertion, subcutaneous tunneling, local disinfection with polyvinyliodide ointment, procedure of mixing the solutions for parenteral feeding, etc. Culture swabs were taken routinely from the feeding solutions and the infusion device. After removing the catheter additional bacteriological studies were performed from the catheter tip and the skin at the site of insertion. Although the results showed a low incidence of contamination at the infusion device (1.1%) and the parenteral solutions (3.6%), the contamination rate of the skin (31.6%) and the catheter tip (35.3%) were exceedingly high. While the bacteriological studies of the infusion and the infusion set showed mostly apathogenous cocci, staphylococci epidermidis and staphylococci aureus were predominant on the skin and the catheter tip. Despite this high contamination rate a catheter related septicaemia was suspected in 17 cases only (7.4%). In six catheters (2.6%) the infection was confirmed by bacteriological results which always showed the typical micro-organisms found on the skin at the catheter insertion site. Therefore, the most important infection route seems to be the way from the skin to the catheter tip. Despite negative bacteriological results in the other eleven catheters a septicaemia was highly suspected on the basis of the laboratory findings.(ABSTRACT TRUNCATED AT 250 WORDS)