Central Line Bundle Implementation in Greek Childrens Hospitals and Impact on Central Line Associated Bloodstream Infections

K. Mougkou, I. Kopsidas, M. Dakoutrou, V. Manesi, A. Bilali, S. Maroudi-Manta, G. Kourlaba, S. Kouni, S.E. Coffin, T.E. Zaoutis
32nd Annual Meeting of the European Society for Paediatric Infectious Diseases (ESPID 2014)
|Dublin, Ireland, May 6-10, 2014

Central line associated bloodstream infection (CLABSI) is the most common healthcare-associated infection in children and is associated with significant morbidity, mortality and costs. To prevent these infections, bundled interventions are recommended. Our aim was to determine the impact of central line (CL) bundle implementation on CLABSI rates in children's hospitals in Greece.

We conducted active surveillance for CLABSIs in pediatric and neonatal intensive care units (ICUs), oncology and transplant unit at 2 affiliated children's hospitals in Athens between October 2012 and September 2013 using the CDC definitions. Unit-specific rates of CLABSI 6 months before and 6 months after implementation of a multifaceted bundle included hand hygiene, chlorhexidine skin antisepsis, maximal barrier precautions, dressing care, and use of an insertion checklist.

We detected 55 CLABSIs and 17,715 CL days in both hospitals. Total CLABSI rates decreased from 5.9 per 1000 CL days in the baseline to 2.8 per 1000 CL days during the post-intervention period (p=0.001). Unit-specific CLABSI rates ranged from 12.3/1000 CL days in the PICUs to 1.4/1000 CL days in Oncology Units. (Table 1) The greatest improvement in CLABSI rates was observed in PICUs.

Associated with implementation of CL bundles that focused on insertion and maintenance of CL, the total CLASBI rate showed a statistically significant decline. This program highlights the impact on CLABSI rates that can be achieved in the first year of a CLABSI prevention program.