Buttera Martina, Luhmann-Lunt Carolyn, Buettcher Michael, Lehnick Dirk, Stocker Martin
Department of Neonatology and Pediatric Intensive Care, Children's Hospital of Central Switzerland, Spitalstrasse, Lucerne, 6000, Switzerland.
Neonatal Intensive Care Unit, Mother and Child Department, Policlinico University Hospital, Modena, Italy.
Antimicrob Resist Infect Control. 2025 Sep 26;14(1):106. doi: 10.1186/s13756-025-01618-2.
Central line-associated bloodstream infections (CLABSIs) are among the most serious infectious complications associated with central lines in neonates. CLABSIs can be prevented by healthcare workers using "bundles" when inserting and managing central lines. These include prompt removal of the central line when it is no longer needed. The aim of this study was to describe and analyze neonatal CLABSIs, focusing on a minimal data set including specific catheter types and dwell times.
A retrospective descriptive study reviewing the management and outcome of neonates with CLABSI admitted to the Department of Neonatology and Neonatal Intensive Care at the Children's Hospital of Central Switzerland in Lucerne from 1 January 2020 to 31 December 2023.
In this four-year period, a total of 27,636 neonates were born in the catchment area and 2599 neonates (9.4%) were admitted to our hospital. In total, 615 neonates (23.7%) had at least one central line with a total of 4940 catheter days. We observed an overall neonatal CLABSI rate of 2.9 per 1,000 catheter days. The rate varied significantly by catheter type: 0 per 1,000 catheter days for umbilical artery catheters (UACs), 0.9 per 1,000 catheter days for peripherally inserted central lines (PICCs), 5.6 per 1,000 catheter days for umbilical venous catheters (UVCs), and 17.9 per 1,000 catheter days for centrally inserted venous catheters (CVCs). All episodes of CLABSI were observed after a dwell time of 5 days, with increasing rates after 9 days.
We observed a pronounced variation in CLABSI rates between different catheter types. All episodes of CLABSI were observed after a dwell time of 5 days, with increasing rates after 9 days, and the rate of CLABSI increased with longer dwell times for UVCs and CVCs. This suggests a reduction in dwell time as a potential strategy for future quality improvement programs aiming for a zero CLABSI rate and underlines the importance of reporting central-line specific dwell-times for future publications.
中心静脉导管相关血流感染（CLABSIs）是新生儿中心静脉导管最严重的感染并发症之一。医护人员在插入和管理中心静脉导管时使用“集束干预措施”可预防CLABSIs。这些措施包括在不再需要中心静脉导管时及时拔除。本研究的目的是描述和分析新生儿CLABSIs，重点关注一个最小数据集，包括特定的导管类型和留置时间。
一项回顾性描述性研究，回顾了2020年1月1日至2023年12月31日在卢塞恩的瑞士中部儿童医院新生儿科和新生儿重症监护室收治的CLABSI新生儿的管理情况和结局。
在这四年期间，集水区共出生27636名新生儿，其中2599名新生儿（9.4%）入院。共有615名新生儿（23.7%）至少有一根中心静脉导管，导管总留置天数为4940天。我们观察到总体新生儿CLABSI发生率为每1000导管日2.9例。发生率因导管类型而异：脐动脉导管（UACs）每1000导管日为0例，外周静脉穿刺中心静脉导管（PICCs）每1000导管日为0.9例，脐静脉导管（UVCs）每1000导管日为5.6例，中心静脉穿刺中心静脉导管（CVCs）每1000导管日为17.9例。所有CLABSI事件均在留置5天后出现，9天后发生率增加。
我们观察到不同导管类型之间CLABSI发生率存在显著差异。所有CLABSI事件均在留置5天后出现，9天后发生率增加，UVCs和CVCs的CLABSI发生率随留置时间延长而增加。这表明缩短留置时间作为未来旨在实现零CLABSI发生率的质量改进计划的潜在策略，强调了在未来出版物中报告中心静脉导管特定留置时间的重要性。
