Bloodstream infections in neonates with central venous catheters in three tertiary neonatal intensive care units in Pune, India

Details

• Alternative Title:
  J Neonatal Perinatal Med
• Personal Author:
  Kartikeswar, G.A.P. ; Parikh, T.B. ; Randive, B. ; Kinikar, A. ; Rajput, U.C. ; Valvi, C. ; Vaidya, U. ; Malwade, S. ; Agarkhedkar, S. ; Kadam, A. ; Smith, R.M. ; Westercamp, M. ; Schumacher, C. ; Mave, V. ; Robinson, M.L. ; Gupta, A. ; Milstone, A.M. ; Manabe, Y.C. ; Johnson, J.
• Description:
  BACKGROUND:
  
  Neonates admitted to the neonatal intensive care unit (NICU) are at risk for healthcare-associated infections, including central line-associated bloodstream infections. We aimed to characterize the epidemiology of bloodstream infections among neonates with central venous catheters admitted to three Indian NICUs.
  
  METHODS:
  
  We conducted a prospective cohort study in three tertiary NICUs, from May 1, 2017 until July 31, 2019. All neonates admitted to the NICU were enrolled and followed until discharge, transfer, or death. Cases were defined as positive blood cultures in neonates with a central venous catheter in place for greater than 2 days or within 2 days of catheter removal.
  
  RESULTS:
  
  During the study period, 140 bloodstream infections were identified in 131 neonates with a central venous catheter. The bloodstream infection rate was 11.9 per 1000 central line-days. Gram-negative organisms predominated, with 38.6% of cases caused by Klebsiella spp. and 14.9% by Acinetobacter spp. Antimicrobial resistance was prevalent among Gram-negative isolates, with 86.9% resistant to third- or fourth-generation cephalosporins, 63.1% to aminoglycosides, 61.9% to fluoroquinolones, and 42.0% to carbapenems. Mortality and length of stay were greater in neonates with bloodstream infection than in neonates without bloodstream infection (unadjusted analysis, p < 0.001).
  
  CONCLUSIONS:
  
  We report a high bloodstream infection rate among neonates with central venous catheters admitted to three tertiary care NICUs in India. Action to improve infection prevention and control practices in the NICU is needed to reduce the morbidity and mortality associated with BSI in this high-risk population.
  
  
• Keywords:
  Antimicrobial Resistance Bloodstream Infection Catheter-Related Infections Catheterization, Central Venous Central Line-associated Bloodstream Infection Central Venous Catheters Cross Infection Healthcare-associated Infection Humans India Infant, Newborn Intensive Care Units, Neonatal Prospective Studies Sepsis

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• Source:
  J Neonatal Perinatal Med. 16(3):507-516
• Pubmed ID:
  37718859
• Pubmed Central ID:
  PMC10875914
• Document Type:
  Journal Article
• Funding:
  K23 HD100594/HD/NICHD NIH HHSUnited States/ ; CC999999/ImCDC/Intramural CDC HHSUnited States/ ; K24 AI141580/AI/NIAID NIH HHSUnited States/ ; UM1 AI069465/AI/NIAID NIH HHSUnited States/ ; UM1 AI068636/AI/NIAID NIH HHSUnited States/ ; UM1 AI068632/AI/NIAID NIH HHSUnited States/ ; UM1 AI104681/AI/NIAID NIH HHSUnited States/
• Volume:
  16
• Issue:
  3
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:848eff092d71b81fe4630e9571176ca0605577054b3bbd7847131e7cbe1e25eb
• Download URL:
  https://stacks.cdc.gov/view/cdc/150270/cdc_150270_DS1.pdf
• File Type:
  [PDF - 583.74 KB ]