OBJECTIVE: To identify risk factors for central line-associated bloodstream infection (BSI) in patients receiving care in a pediatric cardiac intensive care unit. DESIGN: Matched case-control study. SETTING: CICU at Children's Hospital Boston. PATIENTS: Central line-associated BSI cases were identified between April 2004 and December 2006. We identified two randomly selected control patients who had a central vascular catheter and were admitted within 7 days of each index case. MEASUREMENTS AND MAIN RESULTS: Univariate and multivariate conditional logistic regression analyses were used to identify risk factors for central line-associated BSI. In a secondary analysis, risk factors for central line-associated BSI in those cases who underwent cardiac surgery were sought. During the study period, 67 central line-associated BSIs occurred in 61 patients. Independent risk factors for central line-associated BSI were nonelective admission for medical management (odds ratio [OR] = 6.51 [1.58-26.78]), the presence of noncardiac comorbidities (OR = 4.95 [1.49-16.49]), initial absolute neutrophil count <5000 cells/uL (OR = 6.17 [1.39-27.48]), blood product exposure > or =3 units (OR = 5.56 [1.35-22.87]), central line days > or =7 (OR = 6.06 [1.65-21.83]), and use of hydrocortisone (OR = 28.94 [2.55-330.37]). In those patients who underwent cardiac surgery (n = 37 cases and 108 controls), independent risk factors for central line-associated BSI were admission weight < or =5 kg (OR = 3.13 [1.01-9.68]), Pediatric Risk of Mortality III score > or =15 (OR = 3.44 [1.19-9.92]), blood product exposure > or =3 units (OR = 3.38 [1.28-11.76]), and mechanical ventilation for > or =7 days (OR = 4.06 [1.33-12.40]). CONCLUSIONS: Unscheduled medical admissions, presence of noncardiac comorbidities, extended device utilization, and specific medical therapies are independent risk factors for central line-associated BSI in patients receiving care in a pediatric cardiac intensive care unit.
OBJECTIVE: To identify risk factors for central line-associated bloodstream infection (BSI) in patients receiving care in a pediatric cardiac intensive care unit. DESIGN: Matched case-control study. SETTING: CICU at Children's Hospital Boston. PATIENTS: Central line-associated BSI cases were identified between April 2004 and December 2006. We identified two randomly selected control patients who had a central vascular catheter and were admitted within 7 days of each index case. MEASUREMENTS AND MAIN RESULTS: Univariate and multivariate conditional logistic regression analyses were used to identify risk factors for central line-associated BSI. In a secondary analysis, risk factors for central line-associated BSI in those cases who underwent cardiac surgery were sought. During the study period, 67 central line-associated BSIs occurred in 61 patients. Independent risk factors for central line-associated BSI were nonelective admission for medical management (odds ratio [OR] = 6.51 [1.58-26.78]), the presence of noncardiac comorbidities (OR = 4.95 [1.49-16.49]), initial absolute neutrophil count <5000 cells/uL (OR = 6.17 [1.39-27.48]), blood product exposure > or =3 units (OR = 5.56 [1.35-22.87]), central line days > or =7 (OR = 6.06 [1.65-21.83]), and use of hydrocortisone (OR = 28.94 [2.55-330.37]). In those patients who underwent cardiac surgery (n = 37 cases and 108 controls), independent risk factors for central line-associated BSI were admission weight < or =5 kg (OR = 3.13 [1.01-9.68]), Pediatric Risk of Mortality III score > or =15 (OR = 3.44 [1.19-9.92]), blood product exposure > or =3 units (OR = 3.38 [1.28-11.76]), and mechanical ventilation for > or =7 days (OR = 4.06 [1.33-12.40]). CONCLUSIONS: Unscheduled medical admissions, presence of noncardiac comorbidities, extended device utilization, and specific medical therapies are independent risk factors for central line-associated BSI in patients receiving care in a pediatric cardiac intensive care unit.
Authors: Corsino Rey; Francisco Alvarez; Victoria De-La-Rua; Andrés Concha; Alberto Medina; Juan-José Díaz; Sergio Menéndez; Marta Los-Arcos; Juan Mayordomo-Colunga Journal: Intensive Care Med Date: 2011-01-27 Impact factor: 17.440
Authors: V D Rosenthal; B Ramachandran; W Villamil-Gómez; A Armas-Ruiz; J A Navoa-Ng; L Matta-Cortés; M Pawar; A Nevzat-Yalcin; M Rodríguez-Ferrer; R D Yıldızdaş; A Menco; R Campuzano; V D Villanueva; L F Rendon-Campo; A Gupta; O Turhan; N Barahona-Guzmán; O O Horoz; P Arrieta; J M Brito; M C V Tolentino; Y Astudillo; N Saini; N Gunay; G Sarmiento-Villa; E Gumus; A Lagares-Guzmán; O Dursun Journal: Infection Date: 2012-02-28 Impact factor: 3.553
Authors: Scott L Weiss; Mark J Peters; Waleed Alhazzani; Michael S D Agus; Heidi R Flori; David P Inwald; Simon Nadel; Luregn J Schlapbach; Robert C Tasker; Andrew C Argent; Joe Brierley; Joseph Carcillo; Enitan D Carrol; Christopher L Carroll; Ira M Cheifetz; Karen Choong; Jeffry J Cies; Andrea T Cruz; Daniele De Luca; Akash Deep; Saul N Faust; Claudio Flauzino De Oliveira; Mark W Hall; Paul Ishimine; Etienne Javouhey; Koen F M Joosten; Poonam Joshi; Oliver Karam; Martin C J Kneyber; Joris Lemson; Graeme MacLaren; Nilesh M Mehta; Morten Hylander Møller; Christopher J L Newth; Trung C Nguyen; Akira Nishisaki; Mark E Nunnally; Margaret M Parker; Raina M Paul; Adrienne G Randolph; Suchitra Ranjit; Lewis H Romer; Halden F Scott; Lyvonne N Tume; Judy T Verger; Eric A Williams; Joshua Wolf; Hector R Wong; Jerry J Zimmerman; Niranjan Kissoon; Pierre Tissieres Journal: Intensive Care Med Date: 2020-02 Impact factor: 17.440
Authors: Allan Doctor; Jerry Zimmerman; Michael Agus; Surender Rajasekaran; Juliane Bubeck Wardenburg; James Fortenberry; Anne Zajicek; Emma Mairson; Katri Typpo Journal: Pediatr Crit Care Med Date: 2017-03 Impact factor: 3.624
Authors: Jeffrey A Alten; A K M Fazlur Rahman; Hayden J Zaccagni; Andrew Shin; David S Cooper; Joshua J Blinder; Lauren Retzloff; Inmaculada B Aban; Eric M Graham; Jeffrey Zampi; Yuliya Domnina; Michael G Gaies Journal: Pediatr Infect Dis J Date: 2018-08 Impact factor: 2.129