Objective:

To characterize the temporal and anatomic determinants of central line–associated bloodstream infection in a tertiary pediatric intensive care unit using patient-day survival data, focusing on how these factors influence infection risk over time.

Approach:

Key Findings:

• 13 central line–associated bloodstream infections occurred over 4,304 catheter-days (incidence 3.0 per 1,000 catheter-days).
• Adjusted odds of infection were 4.33 (95% CI 1.89–9.92) for dwell time 15-22 days and 11.71 (95% CI 3.22–42.62) for dwell time ≥23 days compared to <14 days.
• Right internal jugular insertion had lower adjusted odds of infection compared to femoral access (adjusted odds ratio 0.34; 95% CI 0.14–0.81).
• Fever in the preceding 24 hours was associated with threefold higher odds of infection (adjusted odds ratio 3.00; 95% CI 0.94–9.52).
• Model demonstrated good discrimination (bias-corrected C-index 0.78; 95% CI 0.70–0.86).

Interpretation:

The risk of central line–associated bloodstream infection is significantly influenced by the duration of catheter dwell time, particularly increasing after two weeks, and is lower with right internal jugular insertion, highlighting the need for targeted clinical interventions.

Limitations:

• Study is retrospective and may be subject to selection bias.
• Findings may not be generalizable to all pediatric intensive care units.
• Potential confounding factors were not fully accounted for in the analysis.

Conclusion:

The study highlights the importance of time-triggered line-necessity reviews and careful consideration of insertion site to reduce infection risk in critically ill children.

Attribution Notice

This content is an AI-generated, fully rewritten summary based on a published scholarly article. It does not reproduce the original text and is not a substitute for the original publication. Readers are encouraged to consult the source for full context, data, and methodology.