Risk factors for peripherally inserted central catheterization-associated bloodstream infection in neonates / 中国当代儿科杂志

OBJECTIVES@#To study the features of catheter-related bloodstream infection (CRBSI) or central line-associated bloodstream infection (CLABSI) after peripherally inserted central catheterization (PICC) in neonates admitted to the neonatal intensive care unit (NICU) and the risk factors for CRBSI or CLABSI.@*METHODS@#A retrospective analysis was performed on the medical data of the neonates who were treated and required PICC in the NICU of the Children's Hospital, Zhejiang University School of Medicine from June 1, 2018 to May 1, 2020. The catheterization-related data were collected, including placement time, insertion site, removal time, and antimicrobial lock of PICC. The multivariate logistic regression model was used to investigate the risk factors for CRBSI or CLABSI in the neonates.@*RESULTS@#A total of 446 neonates were enrolled, with a mean gestational age of (30.8±4.0) weeks, a mean birth weight of (1 580±810) g, a median age of 9 days, and a median duration of PICC of 18 days. The incidence rates of CLABSI and CRBSI were 5.6 and 1.46 per 1 000 catheter days, respectively. Common pathogens for CLABSI caused by PICC included Staphylococcus epidermidis (n=19) and Klebsiella pneumoniae (n=11), and those for CRBSI caused by PICC included Klebsiella pneumoniae (n=6). The risk of CLABSI caused by PICC increased significantly with prolonged durations of PICC and antibiotic use, and the PICC-related infection probability at head and neck was significantly lower than that in the upper and low limbs (P<0.05), while the above conditions were more obvious in neonates with a birth weight of <1 500 g. The risk of CRBSI caused by PICC decreased with the increase in gestational age (P<0.05).@*CONCLUSIONS@#CRBSI and CLABSI remain serious issues in NICU nosocomial infection. The identification of the risk factors for CRBSI and CLABSI provides a basis for improving the quality of clinical care and management.

Preventing of Sterile Phlebitis by Infrared Irradiation after Peripherally Inserted Central Catheterization / 中华医院感染学杂志

OBJECTIVE To study the clinical effect of preventing and treating sterile phlebitis(abacterial phlebitis,SP) by infrared irradiation after peripherally inserted central catheterization(PICC).METHODS Totally 122 inpatients from the Zhejiang Provincial People′s Hospital were divided into two groups randomly,the control group and the experimental group.The control group was only treated with usual care after PICC,while the experimental group with both infrared irradiation and usual care.The incidence rate of SP and its correlation factor were compared between the two groups.RESULTS None in the experimental group got SP.Nevertheless,the control group got a 21.9%incidence rate.The development of SP mostly own to impassable intubation or repeating intubation.CONCLUSIONS For those patients with impassable intubation or repeating intubation during PICC operation,infrared irradiation shows greatly helpful and can obviously prevent the SP and diminish patients′ fee.