“Proactive” management of percutaneously inserted central catheters results in decreased incidence of infection in the ELBW population

被引：50

作者：

Golombek S.G. ^{[1
]}

Rohan A.J. ^{[2
]}

Parvez B. ^{[2
,3
]}

Salice A.L. ^{[2
]}

LaGamma E.F. ^{[1
]}

机构：

[1] The Regional Neonatal Center, New York Medical College, Westchester Medical Center, Valhalla, NY

[2] Department of Pediatrics, University Hospital at Stony Brook, Stony Brook, NY

[3] The Hospital for Sick Children, Toronto, ON, M5G1X8

来源：

Journal of Perinatology | 2002年 / 22卷 / 3期

关键词：

D O I：

10.1038/sj.jp.7210660

中图分类号：

学科分类号：

摘要：

Objective: Extremely low birth weight (ELBW) infants often acquire catheter-related infections (CRIs) when a percutaneously inserted central catheter (PICC) is used for parenteral nutrition or drug administration. Our objective was to compare the incidence of CRIs after we established a "PICC Maintenance Team" for the proactive management - compared to expectant management - of these lines. Study Design: We did a prospective collection and analysis of catheter-related sepsis data over a 15-month period from February 1, 1998 through May 1, 1999. Eligible patients included all neonates weighing < 1000 g at birth. Results: There was a significantly decreased incidence of CRIs, to a rate of 7.1%, or 5.1/1000 catheter days (p < 0.05). Conclusion: "Proactive" management of PICC, significantly reduced the incidence of CRIs. The reduction in infection rate is estimated to save 180 hospitalized patient days/100 very low birth weight neonates, with a concomitant savings in morbidity and medical expense.

引用

页码：209 / 213

页数：4

共 22 条

[11]

Spafford P.S., Sinkin R.A., Cox C., Reubens L., Powell K.R., Prevention of central venous catheter-related coagulase negative Staphylococcus sepsis in neonates, J. Pediatr, 125, pp. 260-263, (1994)

[12]

Mahieu L.M., De Muynck A.O., Leven M.M., De Dooy J.J., Goossens H.J., Van Reempts P.J., Risk factors for central vascular catheter-associated bloodstream infections among patients in a neonatal intensive care unit, J. Hosp. Infect, 48, pp. 108-116, (2001)

[13]

Leick-Rude M.K., Use of percutaneous Silastic intravascular catheters in high risk neonates, Neonat. Network, 9, pp. 17-25, (1990)

[14]

Craft A., Finer N., Nosocomial coagulase negative staphylococcal (CoNS) catheter-related sepsis in preterm infants: Definition, diagnosis, prophylaxis, and prevention, J. Perinatol, 21, pp. 186-192, (2001)

[15]

Salzman M.B., Isenberg H.D., Shapiro J.F., Lipsitz P.J., Rubin L.G., A prospective study of the catheter hub as the portal of entry for microorganisms causing catheter-related sepsis in neonates, J. Infect. Dis, 167, pp. 487-490, (1993)

[16]

Salzman M.B., Rubin L.G., Intravenous catheter-related infections, Adv. Pediatr. Infect. Dis, 10, pp. 337-368, (1995)

[17]

Chathas M.K., Paton J., Fisher D., Percutaneous central venous catheterization: Three years' experience in a neonatal intensive care unit, AJDC, 144, pp. 1246-1250, (1990)

[18]

Goutail-Flaud M., Sfez M., Berg A., Et al., Central venous catheter related complications in newborns and infants: A 587 case survey, J. Pediatr. Surg, 26, pp. 645-650, (1991)

[19]

Stoll B.J., Gordon T., Krones S.B., Et al., Early-onset sepsis in VLBW neonates: A report from the NICHD national research network, J. Pediatr, 129, pp. 72-80, (1996)

[20]

Singhal K.K., LaGamma E.F., Management of 168 neonates weighing more than 2000 g receiving intrapartum chemoprophylaxis for chorioamnionitis, Arch. Pediatr. Adolesc. Med, 150, pp. 158-163, (1996)

← 1 2 3 →