Central- and peripheral-line-associated bloodstream infections in Victorian neonatal intensive care units: findings from a comprehensive Victorian surveillance network, 2008-2024.

BACKGROUND

Neonates face a high risk of healthcare-associated bloodstream infections, leading to increased morbidity and mortality. Effective surveillance is crucial for safe neonatal care and infection prevention.

AIM

To evaluate infection trends, pathogen distribution and antimicrobial resistance patterns in central- and peripheral-line-associated bloodstream infections (CLABSIs and PLABSIs) in Victorian Level 6 neonatal intensive care units between 1 July 2008 and 30 June 2024.

METHODS

Data were collected by the Victorian Healthcare Associated Infection Surveillance System Coordinating Centre using Centers for Disease Control and Prevention National Healthcare Safety Network guidelines. A retrospective data analysis of prospectively collected data was conducted to examine infection epidemiology.

FINDINGS

Overall, 581 neonates developed CLABSIs or PLABSIs, corresponding to a mean CLABSI rate of 2.26 per 1000 central-line-days and a mean PLABSI rate of 0.60 per 1000 peripheral-line-days. The median age at diagnosis of all events was 16 days (interquartile range 9-35 days). No trends were observed in CLASBI or PLABSI rates over the study period. However, an increasing trend in CLABSI rates [incidence risk ratio (IRR) 1.04, 95% confidence interval (CI) 1.00-1.07; P=0.043] and a decreasing trend in PLABSI rates (IRR 0.95, 95% CI 0.92-0.99; P=0.021) were noted among neonates with birth weight ≤750 g. The most frequently reported organisms were coagulase-negative staphylococci, responsible for 44.0% of CLABSIs and 39.5% of PLABSIs.

CONCLUSION

Neonatal intensive care units in Victoria maintained low CLABSI and PLABSI rates over the study period. Higher infection rates in low-birthweight neonates emphasize the need for targeted infection prevention strategies for this vulnerable population.