Background
Bloodstream infection is the most common pediatric health care-associated infection
and is strongly associated with catheter use. These infections greatly increase the
cost of hospital stay.
Methods
To assess the association between needleless connector (NC) change frequency and central
line-associated bloodstream infection (CLABSI) rate, we modeled monthly pediatric
stem cell transplant (SCT) CLABSI rate in 3 periods: baseline period during which
NC were changed every 96 hours regardless of infusate (period 1); trial period in
which NC were changed every 24 hours with blood or lipid infusions (period 2); and
a return to NC change every 96 hours regardless of infusate (period 3). Data on potential
confounders were collected retrospectively. Autocorrelated segmented regression models
were used to compare SCT CLABSI rates in each period, adjusting for potential confounders.
CLABSI rates were also assessed for a nonequivalent control group (oncology unit)
in which NC were changed every 24 hours with blood or lipid use in periods 2 and 3.
Results
SCT CLABSI rates were 0.41, 3.56, and 0.03 per 1,000 central line-days in periods
1, 2, and 3, respectively. In multivariable analysis, the CLABSI rate was significantly
higher in period 2 compared with both period 1 (P = .01) and period 3 (P = .003). In contrast, CLABSI rates on the oncology unit were not significantly different
among periods.
Conclusion
In pediatric SCT patients, changing needleless connectors every 24 hours when blood
or lipids are infused is associated with increased CLABSI rates. National recommendations
regarding NC change frequency should be clarified.
Key Words
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Article info
Footnotes
Conflicts of interest: None to report.
Identification
Copyright
© 2014 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
