Intravenous lines-related sepsis in new born babies admitied to nicu in a developing country

ABSTRACT

Nosocomial sepsis is very common in newborn units in developing countries. Routes of infection are multiple but the personal factor stays important. The hypothesis of the study was that intravenous lines may be important routes of infection and that contamination of cannula hub may precede sepsis episodes. Infants in the neonatal intensive care unit III were enrolled in the study. Culture samples were obtained from the intravenous lines hubs every day until removed. At times of suspected sepsis, all patients had blood obtained for culture from a peripheral vein and from the IV line hubs at the same time. Sepsis was considered IV line related f the microorganism isolated from the peripheral blood culture was identical to the organism recovered from the cannula hub or tip or from purulent material at the site of skin entry of the cannula. 260 lines were placed in 83 patients. 45 episodes of sepsis were diagnosed clinically and by blood culturing. Klebsiella species was the predominant organism. Among the klebsiella cases, the organism was isolated from IV line hub in more than 50% of the cases before the onset of clinical and laboratory sepsis and in 14% of the cases was isolated also from the IV line hub at the time of sepsis. This study supports the hypothesis that cannula hub is a major portal of entry for causing sepsis in newborn units in developing countries