Central Line Associated Bloodstream Infections in Two Greek Children`S Hospitals

K. Mougkou, G. Kourlaba, O. Gerodimou, M. Kazantzi, A. Korkas, H. Petropoulou, G. Sideri, S. Vorre, H. Alexandrou, E. Lebessi, E. Critseli, S. Kouni, N. Spyridis, M. Theodoridou, S. Coffin, T.E. Zaoutis

31st Annual Meeting of the European Society for Paediatric Infectious Diseases (ESPID 2013)
Milan, Italy, May 28-June 1, 2013

BACKGROUND AND AIMS: Central line associated bloodstream infections (CLABSIs) are the most common healthcare-associated infection in children and are associated with significant morbidity, mortality and hospitalization costs. There are no data available on the epidemiology of CLABSIs in hospitalized children in Greece. The study aim was to determine the rate of CLABSIs in the 2 largest children`s hospitals in Greece.

METHODS: We conducted active surveillance for CLABSIs in pediatric and neonatal intensive care units (ICUs), oncology and transplant units between September-December 2012. CLABSIs were prospectively identified using the Centers for Disease Control and Prevention National Healthcare Safety Network definitions. Unit-specific rates of CLABSI (per 1000 catheter days) and device utilization ratios (catheter days per patient days) were calculated.  

RESULTS: During the 4 month surveillance period, 28 CLABSIs and 5907 catheter days were detected. Unitspecific CLABSI rates ranged from 17.2/1000 catheter days in the PICU to 2.4/1000 catheter days in the oncology unit. Device utilization ratios ranged from 0.21 (neonatal ICU) to 0.97 (transplant unit) (Table). Klebsiella was isolated most frequently (23%), followed by Enterobacter (19%), Candida (19%) and Escherichia coli (15%) from specimen cultures.

CONCLUSIONS: High rates of CLABSIs were identified in ICUs while rates were lower in transplant unit despite higher catheter utilization ratios. Infection control programs, including surveillance, evaluations of adherence to best practices of CLABSI prevention, and interventions to prevent CLABSIs, should be urgently implemented in children's hospitals in Greece.