Infections and Impacts of Catheter-related Bloodstream Infection of Pediatric Patients in a University Hospital
Keywords:
Catheter-related bloodstream infection, Impacts, Pediatric patientsAbstract
This retrospective descriptive research aimed to investigate the infections and impacts of catheter-related bloodstream infection in pediatric patients. The samples consisted of 763 medical records of pediatric patients who underwent central venous catheter insertions in a university hospital over a 5-year period. The research instrument was a record form for documenting infections and the impacts of central line-associated bloodstream infection (CLABSI) in pediatric patients. Data were collected from December 2022 to February 2023. Data were analyzed using frequency, percentage, mean, standard deviation, and median, including calculations of CLABSI incidence and case fatality rate.
The research results revealed that the CLABSI incidence rates from 2017 to 2021 were 3.63, 1.64, 1.81, 2.58, and 3.46 per 1,000 central line days, respectively. The CLABSI occurred 79 times in 57 pediatric patients; 59.65% were male, with ages ranging from 14 days to 18 years (M = 2.64 years, SD = 4.64). Additionally, 59.65% of patients were newborns to less than 1 year old, 22.81% were 1–3 years old, and 8.77% were 13–18 years old. The most common causative pathogens were gram-positive bacteria (71.08%), followed by gram-negative bacteria (19.28%), and fungi (9.64%). The average duration of hospitalization was 116.53 days per case (range = 10–676, SD = 122.71). The case fatality rate of CLABSI in pediatric patients was 26.32%. The total cost of medical treatment for CLABSI was 1,339,253.12 baht, with an average cost of 16,952.57 baht per infection.
This research suggests that nurses and infection control nurses should utilize the findings to develop guidelines for the prevention and control of CLABSI in hospitalized pediatric patients.
References
ศศพินทุ์ สุทธิบุณยพันธ์, ศิริพร ผ่องจิตสิริ, และจุฑารัตน์ เมฆมัลลิกา. (2563). อุบัติการณ์ติดเชื้อในกระแสโลหิตที่เกิดในโรงพยาบาลในผู้ป่วยเด็กโรงพยาบาลระดับตติยภูมิ. วารสารกุมารเวชศาสตร์, 59(1), 19–26.
สถาบันบําราศนราดูร. (2568). รายงานประจําปี คณะอนุกรรมการด้านการป้องกันและควบคุมโรคติดเชื้อในโรงพยาบาล ภายใต้คําสั่งคณะกรรมการโรคติดต่อแห่งชาติ ปีงบประมาณ 2567. นนทบุรี: ผู้แต่ง.
หน่วยเวชระเบียน งานเวชระเบียนและสถิติการแพทย์ โรงพยาบาลมหาราชนครเชียงใหม่. (2565). รายงานสถิติประจำปี โรงพยาบาลมหาราชนครเชียงใหม่ คณะแพทยศาสตร์ มหาวิทยาลัยเชียงใหม่. เชียงใหม่: ผู้แต่ง.
Agyeman, P. K. A., Schlapbach, L. J., Giannoni, E., Stocker, M., Posfay-Barbe, K. M., Heininger, U., … Berger, C. (2017). Epidemiology of blood culture-proven bacterial sepsis in children in Switzerland: A population-based cohort study. The Lancet Child & Adolescent Health, 1(2), 124–133. doi:10.1016/S2352-4642(17)30010-X
Alexander, P., & Payal, K. P. (2021). Basic of healthcare epidemiology and infection prevention. In D. J. Weber & T. R. Talbot (Eds.), Mayhall’s hospital epidemiology and infection prevention (pp. 139–152). Philadelphia, PA: Lippincott Williams & Wilkins.
Aloush, S. M., & Alsaraireh, F. A. (2018). Nurses’ compliance with central line associated blood stream infection prevention guidelines. Saudi Medical Journal, 39(3), 273–279. doi:10.15537/smj.2018.3.21497
Asanathong, N. W., Rongrungreung, Y., Assanasen, S., Pumsuwan, V., Wiruchkul, N., Lapphra, K., … Chokephaibulkit, K. (2017). Epidemiology and trends of important pediatric healthcare-associated infections at Siriraj hospital, Thailand. The Southeast Asian Journal of Tropical Medicine and Public Health, 48(3), 641–654. Retrieved from https://www.thaiscience.info/Journals/Article/TMPH/10988363.pdf
Basílico, H., García, S., & Pintos, L. (2021). Risk factors associated with bacteremia in burn children admitted to a specialized pediatric intensive care unit: A case-control study. Archivos Argentinos de Pediatria, 119(5), 325–330. doi:10.5546/aap.2021.eng.325
Bennett, E. E., VanBuren, J., Holubkov, R., & Bratton, S. L. (2018). Presence of invasive devices and risks of healthcare-associated infections and sepsis. Journal of Pediatric Intensive Care, 7(4), 188–195. doi:10.1055/s-0038-1656535
Buetti, N., & Timsit, J. F. (2019). Management and prevention of central venous catheter-related infections in the ICU. Seminars in Respiratory and Critical Care Medicine, 40(4), 508–523. doi:10.1055/s-0039-1693705
Cao, Y., Yan, W. H., Lu, L. N., Tao, Y. J., Feng, H. X., Wu, Q. Q., … Wang, Y. (2022). Catheter-related bloodstream infections in children with intestinal failure: A 6-year review from an intestinal rehabilitation center in China. World Journal of Pediatrics, 18(4), 271–277. doi:10.1007/s12519-022-00519-3
Centers for Disease Control and Prevention. (2017). CLABSI definition with case studies. Retrieved from https://www.cdc.gov/nhsn/pdfs/training/2017/Puckett_March22.pdf
Conley, S. B. (2016). Central line-associated bloodstream infection prevention: Standardizing practice focused on evidence-based guidelines. Clinical Journal of Oncology Nursing, 20(1), 23–26. doi:10.1188/16.Cjon.23-26
Dahan, M., O’Donnell, S., Hebert, J., Gonzales, M., Lee, B., Chandran, A. U., … Quach, C. (2016). CLABSI risk factors in the NICU: Potential for prevention: A PICNIC Study. Infection Control & Hospital Epidemiology, 37(12), 1446–1452. doi:10.1017/ice.2016.203
Dubbink-Verheij, G. H., Bekker, V., Pelsma, I. C. M., Van Zwet, E. W., Smits-Wintjens, V. E. H. J., Steggerda, S. J., … Lopriore, E. (2017). Bloodstream infection incidence of different central venous catheters in neonates: A descriptive cohort study. Frontiers in Pediatrics, 5, 142. doi:10.3389/fped.2017.00142
Gordis, L. (2009). Epidemiology (4th ed.). Philadelphia, PA: Saunders Elsevier.
Gorski, L. A., Hadaway, L., Hagle, M. E., Broadhurst, D., Clare, S., Kleidon, T., ... Alexander, M. (2021). Infusion Therapy Standards of Practice, 8th Edition. Journal of Infusion Nursing, 44(Suppl. 1), S1–S224. doi:10.1097/nan.0000000000000396
Jamshidi, R. (2019). Central venous catheters: Indications, techniques, and complications. Seminars in Pediatric Surgery, 28(1), 26–32. doi:10.1053/j.sempedsurg.2019.01.005
Karagiannidou, S., Zaoutis, T., Maniadakis, N., Papaevangelou, V., & Kourlaba, G. (2019). Attributable length of stay and cost for pediatric and neonatal central line-associated bloodstream infections in Greece. Journal of Infection and Public Health, 12(3), 372–379. doi:10.1016/j.jiph.2018.12.004
Khieosanuk, K., Fupinwong, S., Tosilakul, A., Sricharoen, N., & Sudjaritruk, T. (2022). Incidence rate and risk factors of central line-associated bloodstream infections among neonates and children admitted to a tertiary care university hospital. American Journal of Infection Control, 50(1), 105–107. doi:10.1016/j.ajic.2021.07.016
Kliegman, R. M., Stanton, B. F., St. Geme, J. W., Schor, N. F., & Behrman, R. E. (2016). Nelson textbook of pediatrics (20th ed.). New York: Elsevier.
Nassar, M. Y. H., Salah, M. M., Al Shamahy, H. A., AL Magrami, R. T. F., & Al Moyed, K. A. (2019). Immunoglobulin levels (IgG, IgM and IgA): Normal values for healthy infants and children in Sana’a City- Yemen. Global Journal of Pediatrics & Neonatal Care, 1(5), 1–5. doi:10.33552/GJPNC.2019.01.000525
Nielsen, C. L., Zachariassen, G., & Holm, K. G. (2022). Central line-associated bloodstream infection in infants admitted to a level lllneonatal intensive care unit. Danish Medical Journal, 69(5), A05210463. Retrieved from https://ugeskriftet.dk/files/scientific_article_files/2022-04/a05210463_web.pdf
Pammi, M., Thapa, S., Balderas, M., Runge, J. K., Venkatachalam, A., & Luna, R. A. (2020). Microbiome signatures in neonatal central line associated bloodstream infections. PLoS One, 15(1), e0227967. doi:10.1371/journal.pone.0227967
Pilmis, B., Alby-Laurent, F., Fasola, M. L., Seegers, V., Guery, R., Guet-Revillet, H., … Zahar, J. R. (2020). Pseudomonas aeruginosa bloodstream infections in children: A 9-year retrospective study. European Journal of Pediatrics, 179(8), 1247–1254. doi:10.1007/s00431-020-03598-4
Poh, K. W., Ngan, C. H., Wong, J. Y., Ng, T. K., & Mohd Noor, N. (2020). Reduction of central-line-associated bloodstream infection (CLABSI) in resource limited, nonintensive care unit (ICU) settings. International Journal of Health Care Quality Assurance, 33(2), 210–220. doi:10.1108/IJHCQA-11-2019-0195
Rinke, M. L., Heo, M., Saiman, L., Bundy, D. G., Rosenberg, R. E., DeLaMora, P., … Oyeku, S. O. (2021). Pediatric ambulatory central line-associated bloodstream infections. Pediatrics, 147(1), e20200524. doi:10.1542/peds.2020-0524
Rinke, M. L., Oyeku, S. O., Ford, W. J. H., Heo, M., Saiman, L., DeLaMora, P., … Bundy, D. G. (2020). Costs of ambulatory pediatric healthcare-associated infections: Central-line-associated loodstream infection (CLABSIs), catheter-associated urinary tract infection (CAUTIs), and surgical site infections (SSIs). Infection Control and Hospital Epidemiology, 41(11), 1292–1297. doi:10.1017/ice.2020.305
Stewart, S., Robertson, C., Pan, J., Kennedy, S., Dancer, S., Haahr, L., ... Reilly, J. (2021). Epidemiology of healthcare-associated infection reported from a hospital-wide incidence study: Considerations for infection prevention and control planning. The Journal of Hospital Infection, 114, 10–22. doi:10.1016/j.jhin.2021.03.031
Totonelli, G., Tambucci, R., Boscarelli, A., Hermans, D., Dall’Oglio, L., Diamanti, A., … Fusaro, F. (2018). Pediatric intestinal rehabilitation and transplantation registry: Initial report from a European Collaborative Registry. European Journal of Pediatric Surgery, 28(1), 75–80. doi:10.1055/s-0037-1605349
Veten, A., Davis, J., Kavanagh, R., Thomas, N., & Zurca, A. (2021). Practice patterns of central venous catheter placement and confirmation in pediatric critical care. Journal of Pediatric Intensive Care, 11(3), 254–258. doi:10.1055/s-0041-1723949
Yamaguchi, R. S., Noritomi, D. T., Degaspare, N. V., Muñoz, G. O. C., Porto, A. P. M., Costa, S. F., & Ranzani, O. T. (2017). Peripherally inserted central catheters are associated with lower risk of bloodstream infection compared with central venous catheters in paediatric intensive care patients: A propensity-adjusted analysis. Intensive Care Medicine, 43(8), 1097–1104. doi:10.1007/s00134-017-4852-7
Downloads
Published
How to Cite
Issue
Section
Categories
License
Copyright (c) 2025 Journal of Phrapokklao Nursing College, Chanthaburi
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
เนื้อความ ข้อมูล และรายการอ้างอิงที่ผู้เขียนใช้ในการเขียนบทความเพื่อลงตีพิมพ์ในวารสารวิทยาลัยพยาบาลพระปกเกล้า จันทบุรี ถือเป็นความคิดเห็นและความรับผิดชอบของผู้เขียน คณะผู้จัดทำวารสารไม่จำเป็นต้องเห็นพ้องด้วยหรือร่วมรับผิดชอบ
บทความที่ได้รับการลงตีพิมพ์ในวารสารวิทยาลัยพยาบาลพระปกเกล้า จันทบุรี ถือเป็นลิขสิทธิ์ของวารสารวิทยาลัยพยาบาลพระปกเกล้า จันทบุรี หากหน่วยงานหรือบุคคลใดต้องการนำส่วนหนึ่งหรือทั้งหมดของบทความไปเผยแพร่ต่อเพื่อวัตถุประสงค์ใด ๆ จะต้องได้รับอนุญาตจากบรรณาธิการวารสารก่อน
