Central Venous Catheter Types and Association with Bloodstream Infection in the Pediatric Intensive Care Unit: Experience of two Years

Abstract

Objective: Central venous catheters (CVC) provides great convenience in pediatric intensive care units (PICUs). In this study, we aimed to prospectively examine patients who underwent CVC in the PICU in terms of catheter types and infections Methods: We conducted our monocentric, prospective, and cohort study by including patients between January 2019 and December 2020, involving all central catheters temporarily inserted, except port-line catheters, PICCs, indwelling catheters (cuffed and uncuffed tunnel catheters), and arterial catheters. The main issue we focus on is the rate of catheter-associated bloodstream infection (CLABSI). We analyzed the relationship between infection and risk factors using binary logistic regression analysis. Results: We included 26 CLABSIs with 196 CVCs. The incidence rate was 6.2/1000 catheter days. We found that the incidence of CLABSI increased in femoral catheters (OR: 0.04 p: 0.035, 95% CI: 0.49-3.49). Moreover, the incidence was increased in catheters with 3 lumens (OR: 0.06, p: 0.031, 95% CI: 0.34-1.69). The prolongation of the catheter also increases the risk of infection (OR: 0.06, p: 0.028, 95% CI: 0.56-2.36). Also, we found that the frequency of CLABSI increased in patients with underlying immunodeficiency (OR: 0.19, p: 0.007, 95% CI: 0.85-1.39) and in patients who were given total parenteral nutrition (OR: 0.02, p: 0.041, 95% CI: 0.063-2.38). Conclusion: The number of studies that directly compare catheter types in pediatric patients and their relationship with CLABSI is limited. Moreover, the comparison of unrelated studies is difficult because of heterogeneity in study populations. Multicenter pediatric prospective studies focused on identifying catheter-associated infections are needed.

Keywords

• catheter-associated bloodstream infections
• central venous catheter
• pediatric intensive care unit