Reduction of catheter-associated bloodstream infections through procedures in newborn babies admitted in a university hospital intensive care unit in Brazil.
BACKGROUND
Catheter-associated bloodstream infection (CA-BSI) is the most common nosocomial infection in neonatal intensive care units. There is evidence that care bundles to reduce CA-BSI are effective in the adult literature. The aim of this study was to reduce CA-BSI in a Brazilian neonatal intensive care unit by means of a care bundle including few strategies or procedures of prevention and control of these infections.


METHODS
An intervention designed to reduce CA-BSI with five evidence-based procedures was conducted.


RESULTS
A total of sixty-seven (26.7%) CA-BSIs were observed. There were 46 (32%) episodes of culture-proven sepsis in group preintervention (24.1 per 1,000 catheter days [CVC days]). Neonates in the group after implementation of the intervention had 21 (19.6%) episodes of CA-BSI (14.9 per 1,000 CVC days). The incidence of CA-BSI decreased significantly after the intervention from the group preintervention and postintervention (32% to 19.6%, 24.1 per 1,000 CVC days to 14.9 per 1,000 CVC days, p=0.04). In the multiple logistic regression analysis, the use of more than 3 antibiotics and length of stay >8 days were independent risk factors for BSI.


CONCLUSIONS
A stepwise introduction of evidence-based intervention and intensive and continuous education of all healthcare workers are effective in reducing CA-BSI.
Laboratório de Microbiologia, Instituto de Ciências Biomédicas, Universidade Federal de Uberlândia, Uberlândia, MG, Brasil. daianeresende_bio@hotmail.com
Daiane Silva
DS
Resende
Jacqueline Moreira do
JM
Ó
Denise von Dolinger de
Dv
Brito
Vânia Olivetti Steffen
VO
Abdallah
Paulo Pinto
PP
Gontijo Filho
D016470:Bacteremia / Q000382:microbiology / Q000517:prevention & control*; D001938:Brazil; D055499:Catheter-Related Infections / Q000382:microbiology / Q000517:prevention & control*; D003428:Cross Infection / Q000382:microbiology / Q000517:prevention & control*; D005260:Female; D006785:Hospitals, University; D006801:Humans; D007231:Infant, Newborn; D007318:Inservice Training / Q000379:methods; D007363:Intensive Care Units, Neonatal; D008297:Male; D011159:Population Surveillance; D015397:Program Evaluation; D012307:Risk Factors