PDF icon Download PDF
J Pediatr Intensive Care 2022; 11(03): 240-246
DOI: 10.1055/s-0041-1723946
Original Article

Central Venous Catheter-Related Infectious Complications in Pediatric Surgical Patients: A Single-Center Experience

Rudrashish Haldar
1   Department of Anaesthesiology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
,
Ankur Mandelia 
2   Department of Pediatric Surgery, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
,
Prabhaker Mishra 
3   Department of Biostatistics & Health Informatics, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
,
Ashwani Mishra
2   Department of Pediatric Surgery, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
,
Yousuf Siddiqui
2   Department of Pediatric Surgery, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
› Author Affiliations
Funding None.
› Further Information
Also available ateRef
   Permissions and Reprints
Preview

Abstract

The purpose of this study was to estimate the rate of central venous catheter (CVC) colonization and catheter-related bloodstream infections (CRBSIs) in pediatric surgical patients at our institute and to determine the various risk factors for their occurrence. The electronic medical records of 260 children undergoing surgery with simultaneous CVC insertion were retrospectively reviewed. Data on demographics, primary organ system involved, site of CVC, CVC dwell time, CVC colonization, CRBSI, and organisms isolated on culture were collated, categorized, and analyzed. The rate of CVC colonization and CRBSI was 32.8 per 1,000 catheter days (19.6%) and 17.4 per 1,000 catheter days (10.4%), respectively. Patients with CVC colonization and CRBSI had a significantly higher proportion of patients younger than 1 year of age (p = 0.014). The CVC dwell time was significantly higher in both CVC colonization (7 [5–8] days) and CRBSI (6 [5–9] days) patients (p = 0.005). The frequency of femoral catheterization was significantly higher in patients with CRBSI and CVC colonization (p < 0.001). Coagulase negative staphylococcus was the commonest isolate in CVC infections. Age (adjusted odds ratio [OR] = 0.87; p = 0.009), CVC dwell time (adjusted OR = 1.28; p = 0.003), and femoral CVC (adjusted OR = 9.61; p < 0.001) were independent risk factors for CRBSI. Conclusion: This study reveals important observations regarding the infectious complications of CVC in pediatric surgical patients. The rates of CVC colonization and CRBSI in this study were found to be higher as compared with previously reported rates in Western literature. However, these findings are significant in view of paucity of existing literature in pediatric surgical patients. In our study, higher risk of CRBSI was associated with younger age, increasing CVC dwell time, and femoral venous catheterization. We recommend strict compliance with CVC insertion and maintenance practices and adherence to CVC care bundles to minimize these serious complications.

Keywords

central venous catheter - catheter-related bloodstream infection - pediatric - surgery - children - central line - colonization

Authors' Contributions

All authors contributed to the study conception and design. Material preparation and data retrieval were performed by R.H. and A.M. Statistical analyses were done by P.M. and A.M. The first draft of the manuscript was written by R.H. and A.M. and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.


Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Ethical approval was waived in view of the retrospective nature of the study and all the procedures performed were part of the routine care.




Publication History

Received: 30 October 2020

Accepted: 03 January 2021

Article published online:
17 February 2021

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany