1403 An Audit of Catheter-Associated Bloodstream Infections in a Tertiary Paediatric Intensive Care Unit

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Abstract

Background: We studied the incidence of catheterassociated bloodstream infections (CABSI) in a tertiary specialist 23-bedded paediatric intensivecare unit (PICU). Ongoing surveillance of CABSI incidence is important for continuous quality improvement and maintaining patient safety. There is little published data on the incidence of CABSI in UK paediatric intensive care units.

Methods: We prospectively collected daily clinical and laboratory data on all PICU admissions for four months, retrospectively using electronic patient records to supplement missing data. All positive blood cultures were identified and the total number of catheter days was calculated. We used the UK National Patient Safety Association “Matching Michigan” (MM) case definitions to identify bloodstream infections and CABSI and determined the rate of CABSI.

Results: There were 429 PICU admissions, giving a total of 1578 catheter days. There were 39 positive blood cultures from all sources. The incidence of CABSI was 6.33 per 1000 catheter days. The average length of stay for all patients and those with CABSI was 5 and 17 days respectively.

Conclusion: Although this was a time-limited preliminary audit, our calculated CABSI incidence rate was comparable to that described in the literature. We report some difficulty in using MM case definitions to evaluate our data set and discuss the utility of Systemic Inflammatory Response Syndrome criteria in our population, particularly in post-operative cardiac patients. This audit forms an important first step in the implementation of “care bundles” to reduce modifiable risk factors. It is imperative to establish effective ongoing electronic surveillance of Health Care Associated Infections.

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