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Objectives Central line associated bloodstream infections (CLABSIs) are a major hospital acquired infection (HAI) leading to an increase in morbidity and mortality, as well as economic burden in pediatric patients. 1 2 The incidence, risk factors, microbiological profile and antimicrobial resistance in the PICU may differ from that of the HO unit, warranting the need for studies in our Indian pediatric population, as limited data exists. The objective is to compare CLABSIs in children admitted to the PICU with the HO unit, in terms of incidence, microbiological profile and antimicrobial sensitivity pattern. Methods This is an ongoing prospective observational study in the PICU and HO unit of a tertiary care hospital, among children aged 1 to 18 years. A baseline complete blood count was also recorded. CLABSI bundle was followed prior to insertion, irrespective of type of central line, and followed up till its removal. As per the standard care, in a patient suspected to have CLABSI (clinical signs of infection with no alternate source of blood stream infection), blood cultures were collected from both the central line and peripheral lines, 48 hours after central line insertion, in accordance with CDC guidelines. 3 4 Results A total of 46 patients were analyzed, almost equally distributed with respect to gender (54. 34% females, 45. 65% females). There were 13 children in the HO unit whereas 33 in the PICU. Peripherally inserted central catheter (PICC) lines were more commonly used in the HO unit, as compared to central venous catheters in the PICU, mainly via the jugular vein (63. 04%). The overall CLABSI rate was 9. 65 per 1000 central line days, of which CLABSI rate in the HO unit was 6. 8 and in the PICU was 12. 65 per 1000 central line days respectively. The most common isolated organism belonged to the gram negative species (62. 5%) while the rest were gram positive (25%) and fungal (12. 5%) as shown in figure 1. The total device utilization rate was 0. 82. A favorable outcome was noted in 82. 6% (discharged) while 17. 39% resulted in death. Conclusion CLABSIs prolong stay and cause financial burden. Frequent studies help in early recognition and understanding the trend of HAI. While the analysis of risk factors aids in prevention of CLABSI, knowing antimicrobial resistance patterns assist in the correct choice of antibiotics, in turn reducing duration of stay with favorable positive outcomes. References Diekema DJ, et al. Epidemiology and outcome of nosocomial and community-onset bloodstream infection. J Clin Microbiol, 2003. Scarselli A, et al. The burden of central line-associated bloodstream infections in children with medical complexity. The Journal of Vascular Access. 2021 Jun 21. Bloodstream infection event (central line- associated blood stream infection and non – central line associated bloodstream infections, national healthcare safety network, January 2022, available on: https: //www. cdc. gov/nhsn/pdfs/pscmanual/4pscclabscurrent. pdf, accessed on May 1, 2023. Srinivasan A, et al. Centers for disease control and prevention (cdc). Vital signs: central-line-associated blood stream infections—united states, 2001, 2008, and 2009. Morb Mortal Wkly Rep. 2011.
Bhagwat et al. (Tue,) studied this question.