PDF(Pubmed)
Abstract：
Central line-associated bloodstream infections (CLABSIs) are the most frequent pediatric hospital-acquired infections and significantly impact outcomes. The aim of this study was to estimate the attributable mortality for CLABSIs in pediatric and neonatal patients in Greece. A retrospective matched-cohort study was performed, in two tertiary pediatric hospitals. Inpatients with a central line in neonatal and pediatric intensive care units (NICUs and PICUs), hematology/oncology units, and a bone marrow transplantation unit between June 2012 and June 2015 were eligible. Patients with confirmed CLABSI were enrolled on the day of the event and were matched (1:1) to non-CLABSI patients by hospital, hospitalization unit, and length of stay prior to study enrollment (188 children enrolled, 94 CLABSIs). Attributable mortality was estimated. During the study period, 22 patients with CLABSI and nine non-CLABSI patients died (23.4 vs. 9.6%, respectively, p = 0.011), leading to an attributable mortality of 13.8% (95% confidence interval [CI] = 3.4-24.3%). Children in PICUs were more likely to die, presenting an attributable mortality of 20.2% (95% CI = - 1.4-41.8%), without reaching, however, statistical significance. After multiple logistic regression, patients with CLABSI were four times more likely to die (odds ratio [OR] = 4.29, 95% CI = 1.28-14.36, p = 0.018). Survival analysis showed no difference in time to death after study enrollment between patients with CLABSI and non-CLABSI patients (log-rank p = 0.137, overall median survival time = 7.8 months). Greek pediatric mortality rates are increased by the CLABSI occurrence, highlighting the importance of infection prevention strategies.
摘要：
中心线相关血流感染（CLABSI）是最常见的儿科医院获得性感染，对预后有显著影响。这项研究的目的是估计希腊儿童和新生儿患者CLABSI的归因死亡率。进行了一项回顾性配对队列研究，在两家三级儿科医院。在新生儿和儿科重症监护病房（NICUs和PICUs）中具有中心线的住院患者，血液学/肿瘤学单位，2012年6月至2015年6月之间的骨髓移植单元符合资格.确诊为CLABSI的患者在事件发生当天入组，并通过医院与非CLABSI患者进行匹配（1：1），住院单位,和研究入学前的住院时间(188名儿童入学，94CLABSI).估计了归因死亡率。在学习期间,22例CLABSI患者和9例非CLABSI患者死亡（23.4vs.9.6%,分别,p=0.011),导致13.8%的归因死亡率（95%置信区间[CI]=3.4-24.3%）。PICU中的儿童更容易死亡，归因死亡率为20.2%（95%CI=-1.4-41.8%），没有到达，然而,统计意义。经过多元逻辑回归，CLABSI患者死亡的可能性增加4倍(比值比[OR]=4.29,95%CI=1.28~14.36,p=0.018).生存分析显示，CLABSI患者与非CLABSI患者在研究登记后的死亡时间上没有差异（log-rankp=0.137，总体中位生存时间=7.8个月）。希腊儿科死亡率因CLABSI事件而增加，强调感染预防策略的重要性。
