Abstract:
Background: Central venous line-associated bloodstream infection (CLABSI) is a significant cause of morbidity and mortality in preterm infants. As there is a large variation in the reported effect of multimodal preventive strategies, it could be relevant to propose new additional strategies.
Aim: To assess the impact of a new perfusion system on CLABSI rate.
Methods: We performed a before-and-after study in infants born at < 32 weeks or with a birth weight <1500 g, who required a multi-perfusion system connected to a central venous line. In the first 12-month period ("before"), the pre-existing perfusion system (multiple stopcocks) were used. An intervention period then occurred with implementation of a new perfusion closed system, without change in "bundles" related to various aspects of central lines care. During the second 12-month period ("after") the rate of CLABSI was assessed and compared with pre-intervention period.
Findings: We included 313 infants (“before”: 163; “after”: 150) and 46% had a birthweight <1000 g. The change in perfusion system resulted in a significant decrease in the CLABSI rate (11.3 to 2.2 per 1000 catheter-days, <0.001). The period was independently associated with an 88% reduction in the risk of CLABSI after implementation (OR:0.12, 95%CI [0.03;0.39], P<0.001). The other factor was the duration of central line (for each additional day: 1.05 [1.02;1.07], P<0.001).
Conclusions: The implementation of the new perfusion system was feasible in a large neonatal unit and reduced the rate of CLABSI soon after implementation.
Clinical trial registration: ClinicalTrials.gov, NCT05058534.
Reference:Picaud JC, Faton S, Pradat P, Pastor-Diez B, Martelin A, Armoiry X, Hays S. A new perfusion system to reduce the burden of central venous line-associated bloodstream infections in neonates. J Hosp Infect. 2023 Oct 17:S0195-6701(23)00327-4. doi: 10.1016/j.jhin.2023.10.004. Epub ahead of print. PMID: 37858805.