Presence of Invasive Devices and Risks of Healthcare-Associated Infections and Sepsis

Area of Science:

• Pediatric critical care medicine
• Infectious disease epidemiology
• Medical device safety

Background:

• Healthcare-associated infections and sepsis (HAIS) are significant concerns in pediatric intensive care units (PICUs).
• Invasive devices are frequently used in PICUs but are associated with increased infection risk.

Purpose of the Study:

• To evaluate the daily risk of HAIS events in PICU patients with various invasive devices.
• To identify specific devices contributing most significantly to HAIS risk.

Main Methods:

• Retrospective cohort study design.
• Utilized a multistate hazard model to assess daily HAIS risk.
• Analyzed data from PICU patients with invasive devices.

Main Results:

• Invasive devices were significantly associated with daily HAIS risk (p < 0.05).
• Endotracheal tubes posed the greatest HAIS risk (HR: 4.39, CI: 2.59-7.46).
• Concurrent use of central venous catheters (CVC) and urinary catheters (UC) increased daily risk by over 2.5-fold (HR: 2.59, CI: 1.18-5.68), with individual risks for CVC (HR: 3.06, CI: 1.38-6.77) and UC (HR: 8.9, CI: 3.62-21.91).

Conclusions:

• A multistate hazard model effectively predicts the daily risk of HAIS.
• Identifying high-risk devices like endotracheal tubes and combinations like CVC/UC is crucial for infection prevention strategies in PICUs.