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Risk factors and preventive measures for catheter-related bloodstream infections
Viviane Rosado1, Roberta M C Romanelli, Paulo A M Camargos
1Enfermeira, Comissão de Controle de Infecções Hospitalares, Hospital das Clínicas, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG.
Insights
Identifying central venous catheter (CVC) infection risks in children is key. Implementing preventive measures can significantly reduce CVC-related bloodstream infections, improving patient outcomes.
Area of Science:
- Infectious Diseases
- Pediatric Healthcare
- Medical Device Safety
Background:
- Central venous catheters (CVCs) are essential in pediatric care but pose a risk for bloodstream infections.
- Catheter-related bloodstream infections (CRBSIs) are a significant cause of morbidity and mortality in hospitalized children.
Purpose of the Study:
- To review identified risk factors for central venous catheter-related bloodstream infections (CVCRBSI) in pediatric patients.
- To summarize evidence-based recommendations for the prevention of CVCRBSI.
Main Methods:
- A systematic review of literature published between 2000 and 2010 was conducted.
- Databases searched included PubMed, Cochrane Collaboration, and Bireme.
- Guidelines from the Centers for Disease Control and Prevention and the Brazilian Health Surveillance Agency were also consulted.
Main Results:
- Key risk factors identified include duration of catheter use, length of hospitalization, type of catheter, insertion site (ICU), nonoperative cardiovascular disease, parenteral nutrition, and blood product administration.
- Recommended preventive measures include standardized care protocols, proper insertion techniques, chlorhexidine-impregnated dressings, prompt catheter removal, and ongoing healthcare team education.
Conclusions:
- Controlling identified risk factors can potentially decrease CRBSI incidence by over 40%.
- Enhanced surveillance and standardized care routines for pediatric central venous catheters are crucial for reducing infection rates and enabling benchmarking.
Objective:
To review the risk factors of central venous catheter-related bloodstream infection and the recommendations for its prevention.
Sources:
PubMed, Cochrane Collaboration and Bireme were reviewed using the following inclusion criteria: studies published between 2000 and 2010, study design, hospitalized pediatric population with central venous catheters and studies about central venous catheter-related bloodstream infection. In addition, reference documents were retrieved from the Centers for Disease Control and Prevention and the Brazilian Health Surveillance Agency.
Summary Of The Findings:
Associated risk factors were: duration of central venous catheter use; length of hospitalization time; long-term indwelling central venous catheter; insertion of central venous catheter in intensive care unit; nonoperative cardiovascular disease; parenteral nutrition; and administration of blood products. The preventive measures recommended by studies in the literature are: development of records and multidisciplinary guidelines of care for central venous catheter insertion and maintenance; correct use of central venous catheter insertion technique; use of chlorhexidine-impregnated dressings; early catheter removal; and adoption of continued education programs for the healthcare team.
Conclusion:
The control of risk factors may lead to a reduction of 40% or greater in the incidence of catheter-related bloodstream infection. Insertion surveillance and special attention to central venous catheter in pediatric populations should guide the standardization of healthcare routines to achieve standards for comparisons within and between institutions.
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