Annals of Intensive Care volume 13 , Article number: 50 Cite this article. Metrics details. Rationale: Central lines CL are frequent in pediatrics but implicate some severe complications. CL infection is the main cause of nosocomial infection in pediatrics. Prevalence of CL infection varies a lot depending on the populations studied and there are no recent data regarding the prevalence of severe sepsis due to CL.
Objective : To estimate the prevalence and identify factors associated with occurrence of severe sepsis due to CL associated bloodstream infection CLABSI in pediatrics. Neonatalogy units were excluded. Patients were screened from bacteriological datas. To find potential factors associated with severe sepsis due to CLABSI we performed univariate and multivariate analysis. In univariate analysis, factors associated with the occurrence of severe sepsis due to CLABSI were antibiotic therapy within 3 weeks before, known bacterial colonization, CL daily use and hospitalization in intensive care unit when the CLABSI occurred.
Tachycardia and hypotension at the initial presentation, augmentation of lactate and procalcitonin at the initial biological sample were associated with the occurrence of severe sepsis due to CLABSI. In multivariate analysis, daily use of CL, know bacterial colonization, tachycardia and hypotension were associated with the occurrence of severe sepsis due to CLABSI.
We identified factors associated with the occurrence of severe sepsis complicating CL infection. Those factors should be tested in a prospective multicenter study, to improve our ability to identify patients at risk of severe sepsis and to prevent the evolution to septic shock. This retrospective study is the first step to a prospective multicenter study aiming to optimize the initial treatment and identify children at risk to develop severe sepsis due to CLABSI, in order to improve sepsis bundles application.
Infect Control Hosp Epidemiol. Attributable mortality of central line associated bloodstream infection: systematic review and meta-analysis. Rationale: Pediatric sepsis is the leading cause of mortality in children under five years of age. The latest international guidelines of the Surviving Sepsis Campaign SSC have revised the management of paediatric sepsis, particularly concerning fluid resuscitation.
