Attributable Length of Stay for Pediatric and Neonatal Central Line-Associated Bloodstream Infections

Karagiannidou S., Kourlaba G., Tsopela G.C., Kopsidas J., Zaoutis T.
34th Annual Meeting of the European Society for Paediatric Infectious Diseases (ESPID 2016)
Brighton, UK, May 10-14, 2016

BACKGROUND AND OBJECTIVE: Central line-associated bloodstream infections (CLABSIs) are frequent hospital-acquired infections, related with high morbidity and healthcare costs. Little is known about the attributable length of stay (LOS) due to CLABSI in Greek pediatric and neonatal population, the determination of which was the aim of our study.

METHOD: A retrospective cohort study was performed, in 2 tertiary pediatric hospitals. Inpatients with a central line in NICUs, PICUs, Hematology/Oncology Units and a Bone Marrow Transplantation Unit (BMTU) during the period 6/2012 – 6/2015 were eligible. Patients with confirmed CLABSI were enrolled on the day of the event and were matched (1:1) to ones without CLABSI (non-CLABSIs) by hospital, unit and LOS prior to study enrolment. Our outcome measure was the LOS after the enrollment day. Baseline demographic, hospitalization and central line characteristics along with factors stating severity of illness were also recorded.

RESULTS: Of 189 children studied, 94 presented a CLABSI. There were no differences between the two groups, regarding baseline clinical and demographic characteristics. In the univariate analysis, more CLABSI patients had been transfused with blood products the 14 days prior to study enrollment (84% CLABSI v 70.5% non-CLABSI, p=0.027). The median (25th-75th percentile) LOS was 37 days (18.5-77) and 22 days (13-48) in patients with CLABSI and non-CLABSI, respectively (p=0.009). Multiple regression analysis, showed that LOS and multiple central lines the 14 days prior to patients’ enrollment (p=0.006 & p=0.012, respectively), neutropenia (p=0.002) and CLABSI (p=0.002) were independently associated with higher LOS. The adjusted attributable LOS was found to be 12.4 days.

CONCLUSION: It was found that CLABSI has a significant impact on LOS indicating the need for the implementation of CLABSI prevention initiatives in Greek pediatric and neonatal population.