title: Central-line associated bloodstream infections in a tertiary care children's University hospital: a prospective study.
abstract: The central-line associated bloodstream infections (CLABSI) are the most common healthcare-associated infections in childhood. Despite the international data available on healthcare-associated infections in selected groups of patients, there is a lack of large and good quality studies. The present survey is the first prospective study monitoring for 6 months the occurrence of central-line associated bloodstream infections in all departments of an Italian tertiary care children's university hospital.
  
  
  
  The study involved all children aged less than 18 years admitted to Meyer Children's University Hospital, Florence, Italy who had a central line access between the October 15th, 2014 and the April 14th, 2015. CLABSI were defined according to the Center for Disease Control and Prevention criteria. CLABSI incidence rates with 95% confidence limits were calculated and stratified for the study variables. For each factor the relative risk and 95% confidence intervals were evaluated. Statistical analysis was performed using the statistical software SPSS for Windows, version 22.0 (SPSS Inc., Chicago, IL), p < 0.05 was considered statistically significant.
  
  
  
  CLABSI rate was 3.73/1000 (95% CI: 2.54-5.28) central line-days. A higher CLABSI incidence was seen with female gender (p = 0.045) and underlying medical conditions (excepting prematurity, surgical diseases and malignancy) (p = 0.06). In our study 5 infections, were caused by extended-spectrum β-lactamase producing organisms and in one case by carbapenem-resistant Klebsiella pneumoniae.
  
  
  
  Our study confirms the spreading of multi-resistant pathogens as causes of healthcare associated infections in children. An increased incidence rate of CLABSI in our study was related to underlying medical conditions. Pediatric studies focusing on healthcare infections in this type of patients should be done in order to deepen our understanding on associated risk factors and possible intervention areas.
authors.affiliation: Department of Health Sciences, University of Florence, Meyer Children's University Hospital, Florence, Italy.
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Venturini
authors.affiliation: Department of Health Sciences, University of Florence, Meyer Children's University Hospital, Florence, Italy.
authors.forename: Carlotta
authors.initials: C
authors.lastname: Montagnani
authors.affiliation: Department of Health Sciences, University of Florence, Meyer Children's University Hospital, Florence, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Benni
authors.affiliation: Department of Health Sciences, University of Florence, Meyer Children's University Hospital, Florence, Italy.
authors.forename: Sabrina
authors.initials: S
authors.lastname: Becciani
authors.affiliation: Meyer Children's Hospital Healthcare Associated Infection Control Committee, Florence, Italy.
authors.forename: Klaus Peter
authors.initials: KP
authors.lastname: Biermann
authors.affiliation: Meyer Children's Hospital Healthcare Associated Infection Control Committee, Florence, Italy.
authors.forename: Salvatore
authors.initials: S
authors.lastname: De Masi
authors.affiliation: Department of Health Sciences, University of Florence, Meyer Children's University Hospital, Florence, Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: Chiappini
authors.affiliation: Department of Health Sciences, University of Florence, Meyer Children's University Hospital, Florence, Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: de Martino
authors.affiliation: Department of Health Sciences, University of Florence, Meyer Children's University Hospital, Florence, Italy. luisa.galli@unifi.it.|Meyer Children's Hospital Healthcare Associated Infection Control Committee, Florence, Italy. luisa.galli@unifi.it.|Pediatric Infectious Diseases Division, Department of Pediatric Medicine, Meyer Children's University Hospital, viale Pieraccini 24, I-50139, Florence, Italy. luisa.galli@unifi.it.
authors.forename: Luisa
authors.initials: L
authors.lastname: Galli
mesh_terms: D016470:Bacteremia / Q000453:epidemiology; D055499:Catheter-Related Infections / Q000453:epidemiology*; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D062905:Central Venous Catheters / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D003428:Cross Infection / Q000453:epidemiology; D005260:Female; D006785:Hospitals, University / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D007223:Infant; D007558:Italy / Q000453:epidemiology; D008297:Male; D011446:Prospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D063128:Tertiary Health Care / Q000706:statistics & numerical data
keywords: CLABSI; Central-line; Children; Infection