Background. Central line-associated bloodstream infections (Clabsi) are a preventable cause of morbidity in neonatal intensive care unit (NICU) patients. Aim. To assess, in Belgian NICUs, the compliance to international guidelines for Clabsi-prevention, and to study unit characteristics contributing to Clabsi. Methods. A survey was organized to measure various NICUs adherence to the Clabsi prevention guidelines related to catheter insertion, catheter maintenance and quality control measurements. A Poisson regression model was used to estimate the Clabsi adjusted relative risk for each prevention guideline item implemented. Multivariable linear regression was used to estimate the association between guideline compliance rate and facility characteristics with Clabsi incidence for period 2015-2016. Findings. In Belgium, the overall Clabsi incidence density was 8.48/1000 central line days and was higher in larger NICUs: 10.87‰ vs 6.69‰ (P<0.05). Adherence was highest for the prevention items at catheter insertion (64%) and low for catheter maintenance and quality control items (47% and 50%). Superior adherence to insertion items (P=0.051) and quality performance items (P=0.004) were associated with decreased risk of Clabsi but not for maintenance prevention items (P=0.279). After adjustment for guideline adherence, the size of the NICU was an independent determinant for Clabsi (P=0.002). Conclusions. In Belgium, the NICU’s adherence to international Clabsi prevention guidelines is moderate to poor. NICUs’ compliance to the guidelines is significantly associated with decreased Clabsi rates. The reasons for the gap between NICUs’ current practice and the international prevention guidelines needs further investigation.
Mahieu L, Van Damme K, Mertens K, et al. J Hosp Infect. 2022;S0195-6701(22)00245-6. Doi : 10.1016/j.jhin.2022.07.025. Online ahead of print.