title: Incidence and risk factors for catheter-associated bloodstream infections in neonatal intensive care.
abstract: OBJECTIVE
  To determine the incidence and potential novel risk factors for catheter-associated bloodstream infections (CABSI) in neonates.
  
  
  METHODS
  A retrospective study was conducted for infants admitted to the VU University Medical Center neonatal intensive care unit in 2007.
  
  
  RESULTS
  One hundred and ninety six infants with a total of 369 central catheters were included. The CABSI rate was 18.1 infections/1000 catheter-days (95% CI 13.7-23.8) according to adjusted criteria used by the Centers for Disease Control and Prevention prior to 2008. Umbilical catheters had a higher infection rate than nonumbilical central catheters: rate ratio (rate ratio 2.4, 95% CI 1.2-4.9). Longer umbilical catheter dwell-time also increased infection rate (p < 0.05). Gestational age, birth weight, duration of parenteral nutrition and the administration of all-in-one feeding mixture versus parenteral nutrition administered in separate components were not related to infection rate in multivariate analysis.
  
  
  CONCLUSIONS
  Of all catheter types, umbilical catheters carried the highest infection rate. Longer umbilical catheter dwell-time also increased infection rate. The present data suggest that the impact of gestational age and birth weight on infection rate is mainly due to a prolonged hospital stay. The composition, way of preparation and duration of parenteral nutrition did not seem to influence infection rate.
authors.affiliation: Division of Neonatology, Department of Paediatrics, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Dana F J
authors.initials: DF
authors.lastname: Yumani
authors.forename: Frank A M
authors.initials: FA
authors.lastname: van den Dungen
authors.forename: Mirjam M
authors.initials: MM
authors.lastname: van Weissenbruch
mesh_terms: D055499:Catheter-Related Infections / Q000453:epidemiology*; D062905:Central Venous Catheters / Q000009:adverse effects*; D005260:Female; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal / Q000706:statistics & numerical data; D008297:Male; D015999:Multivariate Analysis; D009426:Netherlands / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D018805:Sepsis / Q000453:epidemiology / Q000209:etiology*