Towards targeting zero CLABSI in umbilical catheterization: insights from a retrospective study

Area of Science:

• Neonatal intensive care
• Infection prevention
• Vascular access devices

Background:

• Umbilical vessel catheterization is crucial for critically ill newborns but carries a high risk of central line-associated bloodstream infections (CLABSI).
• Existing evidence suggests that care bundles can decrease CLABSI incidence related to umbilical catheters.

Purpose of the Study:

• To evaluate the effectiveness of a structured care bundle in reducing CLABSI rates in neonates with umbilical catheters.
• To identify risk factors for CLABSI following the implementation of a care bundle.

Main Methods:

• A prospective, before-and-after cohort study was conducted in a level III NICU.
• Neonates with umbilical catheters were divided into pre-bundle and post-bundle groups.
• The care bundle included standardized protocols for catheter insertion, maintenance, and daily assessment.

Main Results:

• The care bundle significantly reduced CLABSI incidence from 5.43% to 1.06% (p=0.017).
• Mechanical complications decreased significantly from 17.4% to 3.7% (p<0.001).
• Very low birth weight was identified as an independent risk factor for CLABSI (p=0.015), while catheter dwell time was not.

Conclusions:

• A standardized care bundle effectively reduces CLABSI and mechanical complications in neonates with umbilical catheters.
• Very low birth weight remains a critical risk factor, necessitating specialized infection control measures for this population.