Prevention of Late Onset Sepsis and Central-line Associated Blood Stream Infection in Preterm Infants
AIM:Late onset sepsis (LOS) and central-line associated blood stream infection (CLA-BSI) contribute toward the mortality and morbidity in prematurely born infants. The aim of this study is to investigate the effects of hospital-wide and unit-based interventions on LOS and CLA-BSI in infants born at
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| Veröffentlicht in: | The Pediatric infectious disease journal 2016-04, Vol.35 (4), p.401-406 |
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| container_title | The Pediatric infectious disease journal |
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| creator | Sinha, Ajay K Murthy, Vadivelam Nath, Puneet Morris, Joan K Millar, Mike |
| description | AIM:Late onset sepsis (LOS) and central-line associated blood stream infection (CLA-BSI) contribute toward the mortality and morbidity in prematurely born infants. The aim of this study is to investigate the effects of hospital-wide and unit-based interventions on LOS and CLA-BSI in infants born at |
| doi_str_mv | 10.1097/INF.0000000000001019 |
| format | Article |
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METHODS:Intensive care, high dependency days and catheter days were obtained from the unit database and blood culture results from a microbiology laboratory database. Poisson regression was used to evaluate the effects of interventions on LOS and CLA-BSI.
RESULTS:Quarterly rates of LOS reduced from 26.1 to 2.9 per 1000 intensive care, high dependency days and CLA-BSI from 31.6 to 4.3 per 1000 catheter days between 2007 and 2012. Appointment of a hospital specialist vascular device nurse, a change in the mode of administration of vancomycin, standardization of the hospital skin and hub disinfection policy and the introduction of a venous infusion phlebitis scoring system were associated with a reduction of LOS to 55% (95% confidence interval40–74%) and CLA-BSI 45% (95% confidence interval33–61%) of pre-intervention levels. The standardization of the neonatal unit policy for skin disinfection and a move to a new building were associated with reductions of LOS to 64% (47–87%) and 54% (34–88%), respectively, and aseptic no touch technique for infusion access with CLA-BSI to 53% (37–75%) of pre-intervention levels.
CONCLUSION:A multifaceted approach involving changes in antimicrobial and skin disinfection policy, training for aseptic no touch technique and surveillance resulted in sustained reduction in LOS and CLA-BSI rates.</description><identifier>ISSN: 0891-3668</identifier><identifier>EISSN: 1532-0987</identifier><identifier>DOI: 10.1097/INF.0000000000001019</identifier><identifier>PMID: 26629870</identifier><language>eng</language><publisher>United States: Copyright Wolters Kluwer Health, Inc. All rights reserved</publisher><subject>Bacteremia ; Catheter-Related Infections - epidemiology ; Catheter-Related Infections - prevention & control ; Central Venous Catheters - adverse effects ; Cross Infection ; Early Medical Intervention - methods ; Humans ; Infant ; Infant, Newborn ; Seasons ; Sepsis - epidemiology ; Sepsis - etiology ; Sepsis - prevention & control</subject><ispartof>The Pediatric infectious disease journal, 2016-04, Vol.35 (4), p.401-406</ispartof><rights>Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3569-7c54d23c39ab5635bb3fcaae5e0283269ceb32b007c253e48de1b81ca62dcdc3</citedby><cites>FETCH-LOGICAL-c3569-7c54d23c39ab5635bb3fcaae5e0283269ceb32b007c253e48de1b81ca62dcdc3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26629870$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Sinha, Ajay K</creatorcontrib><creatorcontrib>Murthy, Vadivelam</creatorcontrib><creatorcontrib>Nath, Puneet</creatorcontrib><creatorcontrib>Morris, Joan K</creatorcontrib><creatorcontrib>Millar, Mike</creatorcontrib><title>Prevention of Late Onset Sepsis and Central-line Associated Blood Stream Infection in Preterm Infants</title><title>The Pediatric infectious disease journal</title><addtitle>Pediatr Infect Dis J</addtitle><description>AIM:Late onset sepsis (LOS) and central-line associated blood stream infection (CLA-BSI) contribute toward the mortality and morbidity in prematurely born infants. The aim of this study is to investigate the effects of hospital-wide and unit-based interventions on LOS and CLA-BSI in infants born at <32 weeks gestation.
METHODS:Intensive care, high dependency days and catheter days were obtained from the unit database and blood culture results from a microbiology laboratory database. Poisson regression was used to evaluate the effects of interventions on LOS and CLA-BSI.
RESULTS:Quarterly rates of LOS reduced from 26.1 to 2.9 per 1000 intensive care, high dependency days and CLA-BSI from 31.6 to 4.3 per 1000 catheter days between 2007 and 2012. Appointment of a hospital specialist vascular device nurse, a change in the mode of administration of vancomycin, standardization of the hospital skin and hub disinfection policy and the introduction of a venous infusion phlebitis scoring system were associated with a reduction of LOS to 55% (95% confidence interval40–74%) and CLA-BSI 45% (95% confidence interval33–61%) of pre-intervention levels. The standardization of the neonatal unit policy for skin disinfection and a move to a new building were associated with reductions of LOS to 64% (47–87%) and 54% (34–88%), respectively, and aseptic no touch technique for infusion access with CLA-BSI to 53% (37–75%) of pre-intervention levels.
CONCLUSION:A multifaceted approach involving changes in antimicrobial and skin disinfection policy, training for aseptic no touch technique and surveillance resulted in sustained reduction in LOS and CLA-BSI rates.</description><subject>Bacteremia</subject><subject>Catheter-Related Infections - epidemiology</subject><subject>Catheter-Related Infections - prevention & control</subject><subject>Central Venous Catheters - adverse effects</subject><subject>Cross Infection</subject><subject>Early Medical Intervention - methods</subject><subject>Humans</subject><subject>Infant</subject><subject>Infant, Newborn</subject><subject>Seasons</subject><subject>Sepsis - epidemiology</subject><subject>Sepsis - etiology</subject><subject>Sepsis - prevention & control</subject><issn>0891-3668</issn><issn>1532-0987</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kMtKAzEUQIMotlb_QCRLN1PzmOdSi9VCsUK7HzKZO3Q0k9QkY_HvjW0VcWE2F8K558JB6JKSMSVFdjN7mo7Jr0cJLY7QkCacRaTIs2M0JHlBI56m-QCdOfcSIB5TcooGLE1ZQMgQwbOFd9C-NRqbBs-FB7zQDjxewsa1Dgtd40kArFCRajXgW-eMbANX4ztlTI2X3oLo8Ew3IHeeVuNg9WB3n0J7d45OGqEcXBzmCK2m96vJYzRfPMwmt_NI8iQtokwmcc245IWokpQnVcUbKQQkQFjOWVpIqDirCMkkSzjEeQ20yqkUKatlLfkIXe-1G2veenC-7FonQSmhwfSupFkWPAkjNKDxHpXWOGehKTe27YT9KCkpv_qWoW_5t29Yuzpc6KsO6p-l76AByPfA1qhQwL2qfgu2XINQfv2_-xPOioda</recordid><startdate>201604</startdate><enddate>201604</enddate><creator>Sinha, Ajay K</creator><creator>Murthy, Vadivelam</creator><creator>Nath, Puneet</creator><creator>Morris, Joan K</creator><creator>Millar, Mike</creator><general>Copyright Wolters Kluwer Health, Inc. All rights reserved</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201604</creationdate><title>Prevention of Late Onset Sepsis and Central-line Associated Blood Stream Infection in Preterm Infants</title><author>Sinha, Ajay K ; Murthy, Vadivelam ; Nath, Puneet ; Morris, Joan K ; Millar, Mike</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3569-7c54d23c39ab5635bb3fcaae5e0283269ceb32b007c253e48de1b81ca62dcdc3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Bacteremia</topic><topic>Catheter-Related Infections - epidemiology</topic><topic>Catheter-Related Infections - prevention & control</topic><topic>Central Venous Catheters - adverse effects</topic><topic>Cross Infection</topic><topic>Early Medical Intervention - methods</topic><topic>Humans</topic><topic>Infant</topic><topic>Infant, Newborn</topic><topic>Seasons</topic><topic>Sepsis - epidemiology</topic><topic>Sepsis - etiology</topic><topic>Sepsis - prevention & control</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Sinha, Ajay K</creatorcontrib><creatorcontrib>Murthy, Vadivelam</creatorcontrib><creatorcontrib>Nath, Puneet</creatorcontrib><creatorcontrib>Morris, Joan K</creatorcontrib><creatorcontrib>Millar, Mike</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Pediatric infectious disease journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Sinha, Ajay K</au><au>Murthy, Vadivelam</au><au>Nath, Puneet</au><au>Morris, Joan K</au><au>Millar, Mike</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prevention of Late Onset Sepsis and Central-line Associated Blood Stream Infection in Preterm Infants</atitle><jtitle>The Pediatric infectious disease journal</jtitle><addtitle>Pediatr Infect Dis J</addtitle><date>2016-04</date><risdate>2016</risdate><volume>35</volume><issue>4</issue><spage>401</spage><epage>406</epage><pages>401-406</pages><issn>0891-3668</issn><eissn>1532-0987</eissn><abstract>AIM:Late onset sepsis (LOS) and central-line associated blood stream infection (CLA-BSI) contribute toward the mortality and morbidity in prematurely born infants. The aim of this study is to investigate the effects of hospital-wide and unit-based interventions on LOS and CLA-BSI in infants born at <32 weeks gestation.
METHODS:Intensive care, high dependency days and catheter days were obtained from the unit database and blood culture results from a microbiology laboratory database. Poisson regression was used to evaluate the effects of interventions on LOS and CLA-BSI.
RESULTS:Quarterly rates of LOS reduced from 26.1 to 2.9 per 1000 intensive care, high dependency days and CLA-BSI from 31.6 to 4.3 per 1000 catheter days between 2007 and 2012. Appointment of a hospital specialist vascular device nurse, a change in the mode of administration of vancomycin, standardization of the hospital skin and hub disinfection policy and the introduction of a venous infusion phlebitis scoring system were associated with a reduction of LOS to 55% (95% confidence interval40–74%) and CLA-BSI 45% (95% confidence interval33–61%) of pre-intervention levels. The standardization of the neonatal unit policy for skin disinfection and a move to a new building were associated with reductions of LOS to 64% (47–87%) and 54% (34–88%), respectively, and aseptic no touch technique for infusion access with CLA-BSI to 53% (37–75%) of pre-intervention levels.
CONCLUSION:A multifaceted approach involving changes in antimicrobial and skin disinfection policy, training for aseptic no touch technique and surveillance resulted in sustained reduction in LOS and CLA-BSI rates.</abstract><cop>United States</cop><pub>Copyright Wolters Kluwer Health, Inc. All rights reserved</pub><pmid>26629870</pmid><doi>10.1097/INF.0000000000001019</doi><tpages>6</tpages></addata></record> |
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| subjects | Bacteremia Catheter-Related Infections - epidemiology Catheter-Related Infections - prevention & control Central Venous Catheters - adverse effects Cross Infection Early Medical Intervention - methods Humans Infant Infant, Newborn Seasons Sepsis - epidemiology Sepsis - etiology Sepsis - prevention & control |
| title | Prevention of Late Onset Sepsis and Central-line Associated Blood Stream Infection in Preterm Infants |
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