Central venous catheter-related bloodstream infection in a pediatric hospital: A prospective study

Central venous catheter (CVC) are very useful in pediatrics but are a common source of nosocomial bloodstream infection. A prospective and exhaustive study was undertaken at the children hospital Armand-Trousseau, to determine the incidence of those infections. Between November 1, 1993 and April 30, 1994, 128 CVC were inserted in 126 patients (55 neonates, 23 infants and 48 children), from 8 departments. Data about CVC insertion methods and positive blood cultures were collected by questionnary. Seventeen primary bloodstream infections occured in 15 patients, for a total CVC days of 2720. The overall incidence was 6.2/1000 days. The incidence of primary bloodstream infection varied with age from 9.3/1000 days in neonate to 4.3/1000 days in children, but was not influenced by the type of CVC or method of insertion. Causative organisms were most commonly S. epidermidis. Recovery occured in all cases, with CVC removal in only 2 cases. This study was the first step of a multidisciplinary collaboration to evaluate and improve health care practices to patients with CVC.