Abstract:
Background: Neonates face a high risk of healthcare-associated bloodstream infections, leading to increased morbidity and mortality. Effective surveillance is crucial for safe neonatal care and infection prevention.
Aim: This study aimed to evaluate infection trends, pathogen distribution, and antimicrobial resistance patterns in central and peripheral line-associated bloodstream infections (CLABSIs and PLABSIs) in Victorian Level 6 neonatal intensive care units between July 1st, 2008, and June 30th, 2024.
Methods: Data were collected by the Victorian Healthcare Associated Infection Surveillance System Coordinating Centre using CDC National Healthcare Safety Network guidelines. A retrospective data analysis of prospectively collected data was conducted to examine infection epidemiology.
Findings: Overall, 581 neonates developed CLABSIs or PLABSIs, corresponding to a mean CLABSI rate of 2.26 per 1,000 central line-days and a mean PLABSI rate of 0.60 per 1,000 peripheral line-days. The median age at diagnosis of all events was 16 days (IQR 9-35 days). No trends were observed in CLASBI or PLABSI rates over the study period. However, an increasing trend in CLABSI rates (IRR: 1.04, 95% CI: 1.00, 1.07, p = 0.043) and a decreasing trend in PLABSI rates (IRR: 0.95, 95% CI: 0.92, 0.99, p = 0.021) were noted among neonates with birth weight ≤750g. The most frequently reported organism was coagulase-negative Staphylococcus, responsible for 44.0% of CLABSIs and 39.5% of PLABSIs.
Conclusion: NICUs in Victoria have maintained low CLABSI and PLABSI rates over the study period. Higher infection rates in low-birth-weight neonates emphasize the need for targeted infection prevention strategies for this vulnerable population.
Reference:Liu ZR, Bull AL, Phuong LK, Malloy MJ, Friedman ND, Worth LJ. Central and peripheral line-associated bloodstream infections in Victorian neonatal intensive care units: findings from a comprehensive Victorian surveillance network, 2008-2024. J Hosp Infect. 2025 Apr 26:S0195-6701(25)00099-4. doi: 10.1016/j.jhin.2025.04.009. Epub ahead of print. PMID: 40294873.