Intravenous lines-related sepsis in newborn babies admitted to NICU in a developing country

Nosocomial sepsis is very common in newborn units in developing countries. Routes of infection are multiple but the personal factor stays important. The hypothesis of this study was that intravenous lines may be important routes of infection and that contamination of cannula hub may preceded sepsis episodes. Infants in the neonatal intensive care unit level III were enrolled in the study. Culture samples were obtained from the intravenous line hubs every day until removed. At times of suspected sepsis, all patients had blood obtained for culture from a peripheral vein and from the i.v. line hubs at the same time. Sepsis was considered i.v. line-related if the micro-organism isolated from the peripheral blood culture was identical to the organism recovered from the cannula hub or tip or from purulent material at the site of skin entry of the cannula. Two hundred and sixty lines were placed in 83 patients. Forty-five episodes of sepsis were diagnosed clinically and by blood culturing. Klebsiella species was the predominant organism. Among the Klebsiella cases, the organism was isolated from the i.v. line hub in more than 50 per cent of the cases before the onset of clinical and laboratory sepsis, and in 14 per cent of the cases it was also isolated from the i.v. line hub at the time of sepsis. This study supports the hypothesis that the cannula hub is a major portal of entry for causing sepsis in newborn units.