Is Bloodstream Infection Preventable Among Premature Infants? A Tale of Two Cities

Bloodstream infection (BSI) is a significant cause of morbidity and death encountered in the NICU. The rates of BSIs vary significantly in NICUs across the nation. However, no attempt has been made to correlate this variation with specific infection-control practices and policies. We experienced a s...

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Bibliographic Details
Published in:Pediatrics (Evanston) 2005-06, Vol.115 (6), p.1513-1518
Main Authors: Aly, Hany, Herson, Victor, Duncan, Anne, Herr, Jill, Bender, Jean, Patel, Kantilal, El-Mohandes, Ayman A. E
Format: Article
Language:English
Subjects:
Asepsis - methods
Asepsis - standards
Babies
Bacterial diseases
Bacterial sepsis
Bandages
Biological and medical sciences
Blood
Care and treatment
Catheterization
Catheterization, Central Venous - adverse effects
Catheterization, Central Venous - methods
Catheterization, Peripheral - adverse effects
Catheterization, Peripheral - methods
Circulatory system
Connecticut
Cross Infection - etiology
Cross Infection - prevention & control
Diagnosis
Diseases
District of Columbia
Equipment Contamination - prevention & control
General aspects
Hospitals, Pediatric - organization & administration
Hospitals, University - organization & administration
Human bacterial diseases
Humans
Infant, Low Birth Weight
Infant, Newborn
Infant, Premature
Infant, Premature, Diseases - etiology
Infant, Premature, Diseases - prevention & control
Infant, Very Low Birth Weight
Infants
Infants (Newborn)
Infection Control - organization & administration
Infections
Infectious diseases
Infusions, Intravenous - instrumentation
Infusions, Intravenous - nursing
Intensive Care, Neonatal - methods
Intensive Care, Neonatal - standards
Klebsiella Infections - etiology
Klebsiella Infections - prevention & control
Medical sciences
Neonatal diseases
Organizational Policy
Pediatrics
Premature birth
Prevention
Retrospective Studies
Risk Factors
Sepsis
Sepsis - etiology
Sepsis - prevention & control
Staphylococcal Infections - etiology
Staphylococcal Infections - prevention & control
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Summary:Bloodstream infection (BSI) is a significant cause of morbidity and death encountered in the NICU. The rates of BSIs vary significantly in NICUs across the nation. However, no attempt has been made to correlate this variation with specific infection-control practices and policies. We experienced a significant increase in BSIs in the NICU at the George Washington University Hospital and were seeking additional precautionary measures to reduce BSI rates. Our objective was to review policies and practices associated with lower infection rates nationally and to test their reproducibility in our unit. Data on BSI rates in 16 NICUs were reviewed. The BSI rate at Connecticut Children's Medical Center (CCMC) was the lowest among those reviewed. A team from George Washington University Hospital conducted a site visit to CCMC to examine their practices. Differences in the aseptic precautions used for intravenous line management were noted at CCMC, where a closed medication system is used. This system was applied at George Washington University Hospital starting January 1, 2001. Infection rates among low birth weight infants (
ISSN:0031-4005
1098-4275
DOI:10.1542/peds.2004-1785