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Effectiveness of a program for the reduction of central venous catheter-related bacteremias in a Pediatric

Silvina Ruvinsky1, Norma Aquino2, Ana M Lenz3

  • 1Servicio de Epidemiología e Infectología, Hospital de Pediatría S.A.M.I.C. Prof. Dr. Juan P. Garrahan, Ciudad Autónoma de Buenos Aires, Argentina. sruvinsky@hotmail.com.

Archivos Argentinos De Pediatria
|October 3, 2022
PubMed

Insights

An interdisciplinary program significantly reduced central venous catheter (CVC)-related bacteremias in pediatric cardiac intensive care units. This initiative improved patient outcomes by lowering infection rates in high-risk surgical patients.

Area of Science:

  • Pediatric Cardiac Intensive Care
  • Infection Prevention
  • Clinical Quality Improvement

Background:

  • Central venous catheter (CVC)-related bacteremias are a significant cause of morbidity and mortality in pediatric patients undergoing surgery for complex congenital heart disease.
  • These infections are particularly prevalent in the pediatric cardiac intensive care unit (PCICU) setting.

Purpose of the Study:

  • To evaluate the effectiveness of an interdisciplinary program designed to prevent CVC-related bacteremias in the PCICU.
  • To analyze the impact of the program on infection rates and CVC utilization.

Main Methods:

  • A quasi-experimental, before-and-after study design was employed from 2008 to 2018.
  • The study involved PCICU staff caring for post-surgical complex heart disease patients, with an intervention period from 2009 to 2018.
  • Key metrics analyzed included CVC-related bacteremia rates, CVC use, RACHS score, and standardized infection ratio (SIR).

Main Results:

  • The baseline bacteremia rate was 11.9 per 1000 CVC days, which significantly decreased to 3.8 per 1000 CVC days post-intervention (RR: 0.16; 95% CI: 0.07-0.35; p < 0.001).
  • A statistically significant reduction in the SIR was observed annually (p < 0.05).
  • The RACHS score remained consistent, indicating the observed reduction was not due to changes in patient severity.

Conclusions:

  • The implemented interdisciplinary program proved effective in reducing CVC-related bacteremias within the PCICU.
  • The findings demonstrate a progressive and statistically significant decline in infection rates, highlighting the program's success in improving patient safety.
Abstract

Keywords:
bacteremiacentral venous cathetersinfection controlinfectionsintensive care units

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