Intravascular catheter colonization and related bloodstream infection in critically ill neonates.
Intravascular catheter tip colonization was prospectively evaluated in critically ill neonates to determine its relationship to the type of device used, duration of catheterization, insertion site and nosocomial bloodstream infection. Sixty-one percent (376 of 621) of all intravascular catheter tips were retrieved from 91 infants. Thirteen percent (41 of 310) of peripheral intravenous, 14% (6 of 42) of umbilical, 21% (3 of 11) of central venous, 36% (4 of 11) of peripheral arterial and 100% (2 of 2) of femoral catheters were colonized. Duration of catheterization was significantly longer for colonized lines (p less than .001). Eight of 26 (30.8%) peripheral intravenous catheters remaining in place for more than three days were colonized, compared with 33 of 284 (11.6%) at three days or less (p = 0.012). Coagulase-negative staphylococcus was the organism most frequently isolated from catheter tips and bloodstream infections. Catheter colonization rates in this population were higher than those found in adults. Heavily manipulated devices and those in place for longer periods of time were the most frequently colonized.
Cronin
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Department of Internal Medicine, Hospital Epidemiology, University of Virginia Health Sciences Center, Charlottesville 22908.
Germanson
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Donowitz
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D000367:Age Factors; D002408:Catheters, Indwelling / Q000009:adverse effects*; D006801:Humans; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000209:etiology*; D010865:Pilot Projects; D011446:Prospective Studies; D012127:Respiratory Distress Syndrome, Newborn / Q000628:therapy; D018805:Sepsis / Q000209:etiology*; D013203:Staphylococcal Infections / Q000209:etiology*; D013212:Staphylococcus epidermidis