title: Prospective study on central venous line associated bloodstream infections.
abstract: OBJECTIVE
  To prospectively assess the incidence rates and characteristics of central venous line associated bloodstream infections (CLABSI) in one institution.
  
  
  METHODS
  All patients with indwelling central venous catheters (CVC) between 1 April 2008 and 31 March 2009 were enrolled. The medical records of patients were reviewed and information on relevant characteristics entered into a standardised questionnaire. Central laboratory records were regularly checked for positive blood cultures in study patients.
  
  
  RESULTS
  There were 209 CVC for a total of 14752 CVC days in 152 patients (88 males, 58%) including neonates and patients with surgical conditions and haemato-oncological and other underlying diseases. Median age at CVC insertion was 3 months (IQR 0-56 months). Fourteen CLABSI occurred in 13 patients. Overall CLABSI incidence (per 1000 CVC days) was 0.95 (9.71 for silastic percutaneous CVC, 7.65 for other CVC, 1.97 for Broviac, 0.18 for Port-a-cath). CVC remained in place for ≤ 14 days in 109 (52%) instances, 15-90 days in 45 (22%) instances and > 90 days in 55 (26%) instances. The incidence of CLABSI in these three categories was 3.36, 4.36 and 0.47, respectively. Predominating cultured organisms were coagulase-negative staphylococci (N=3), S. aureus (N=3), and Enterococcus spp. (N=3).
  
  
  CONCLUSIONS
  CLABSI incidence varied by type of catheter and type of patient, with the highest risk in neonates (with silastic percutaneous CVC) and by far the lowest risk for Port-a-cath CVC. Prophylactic measures to reduce CLABSI should be tailored to individual types of catheters and patient characteristics.
authors.affiliation: University Children's Hospital Basel (UKBB), PO Box CH-4005, Basel, Switzerland.
authors.forename: Mine
authors.initials: M
authors.lastname: Wagner
authors.forename: Jan
authors.initials: J
authors.lastname: Bonhoeffer
authors.forename: Thomas O
authors.initials: TO
authors.lastname: Erb
authors.forename: René
authors.initials: R
authors.lastname: Glanzmann
authors.forename: Frank Martin
authors.initials: FM
authors.lastname: Häcker
authors.forename: Michael
authors.initials: M
authors.lastname: Paulussen
authors.forename: Daniel
authors.initials: D
authors.lastname: Weibel
authors.forename: Ulrich
authors.initials: U
authors.lastname: Heininger
mesh_terms: D016470:Bacteremia / Q000209:etiology*; D058387:Candidemia / Q000209:etiology; D055499:Catheter-Related Infections / Q000209:etiology*; D002405:Catheterization, Central Venous / Q000009:adverse effects* / Q000295:instrumentation / Q000379:methods; D002675:Child, Preschool; D003428:Cross Infection / Q000209:etiology*; D004812:Epidemiologic Methods; D004866:Equipment Contamination; D005260:Female; D006757:Hospital Units; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male