Indian Journal of Critical Care Medicine

Register      Login



Volume / Issue

Online First

Related articles

VOLUME 17 , ISSUE 3 ( June, 2013 ) > List of Articles


Catheter related blood stream infections in the paediatric intensive care unit: A descriptive study

Diana Thomas, Narayanan Parameswaran, B. N. Harish

Keywords : Catheter related blood stream infections, nosocomial infections, pediatric intensive care unit

Citation Information : Thomas D, Parameswaran N, Harish BN. Catheter related blood stream infections in the paediatric intensive care unit: A descriptive study. Indian J Crit Care Med 2013; 17 (3):135-139.

DOI: 10.4103/0972-5229.117038

License: CC BY-ND 3.0

Published Online: 01-06-2013

Copyright Statement:  Copyright © 2013; The Author(s).


Context: Catheter related blood stream infections (CRBSI) contributes significantly to morbidity, mortality and costs in intensive care unit (ICU). The patient profile, infrastructure and resources in ICU are different in the developing world as compared to western countries. Studies regarding CRBSI from pediatric intensive care unit (PICU) are scanty in the Indian literature. Aims: To determine the frequency and risk factors of CRBSI in children admitted to PICU. Settings and Design: Descriptive study done in the PICU of a tertiary care teaching hospital over a period of four months. Materials and Methods: Study children were followed up from the time of catheterization till discharge. Their clinical and treatment details were recorded and blood culture was done every 72 h, starting at 48 h after catheterization. The adherence of doctors to Centre for Disease Control (CDC) guidelines for catheter insertion was assessed using a checklist. Statistical Analysis: Clinical parameters were compared between colonized and non-colonized subjects and between patients with and without CRBSI. Unpaired t-test and Chi-square test were used to test the significance of observed differences. Results: Out of the 41 children, 21 developed colonization of their central venous catheter (66.24/1000 catheter days), and two developed CRBSI (6.3/1000 catheter days). Infants had a higher risk for developing colonization (P = 0.01). There was 85% adherence to CDC guidelines for catheter insertion. Conclusions: The incidence of CRBSI and catheter colonization is high in our in spite of good catheter insertion practices. Hence further studies to establish the role of adherence to catheter maintenance practices in reducing risk of CRBSI is required. The role of a composite package of interventions including insertion and maintenance bundles specifically targeting infants needs to be studied to bring down the catheter colonization as well as CRBSI rates.

PDF Share
  1. Rao S, Alladi A, Das K, Cruz AJ. Medium and long term central venous access in children. Indian Pediatr 2003;40:41-4.
  2. Sachdev A, Gupta DK, Soni A, Chugh K. Central venous catheter colonization and related bacteremia in pediatric intensive care unit. Indian Pediatr 2002;39:752-60.
  3. Chopdekar K, Chande C, Chavan S, Veer P, Wabale V, Vishwakarma K, et al. Central venous catheter-related blood stream infection rate in critical care units in a tertiary care, teaching hospital in Mumbai. Indian J Med Microbiol 2011;29:169-71.
  4. Edwards JR, Peterson KD, Mu Y, Banerjee S, Allen-Bridson K, Morrell G, et al. National Healthcare Safety Network (NHSN) report: Data summary for 2006 through 2008, issued December 2009. Am J Infect Control 2009;37:783-805.
  5. National Nosocomial Infections Surveillance (NNIS) system report, data summary from January 1992-April 2000, issued June 2000.Am J Infect Control 2000;28:429-48.
  6. O′Grady NP, Alexander M, Burns LA, Dellinger EP, Garland J, Heard SO, et al. Summary of recommendations: Guidelines for the Prevention of Intravascular Catheter-related Infections. Clin Infect Dis 2011;52:1087-99.
  7. Henrickson KJ, Axtell RA, Hoover SM, Kuhn SM, Pritchett J, Kehl SC, et al. Prevention of central venous catheter-related infections and thrombotic events in immunocompromised children by the use of vancomycin/ciprofloxacin/heparin flush solution: A randomized, multicenter, double-blind trial. J Clin Oncol 2000;18:1269-78.
  8. Mermel LA. Prevention of intravascular catheter-related infections. Ann Intern Med 2000;132:391-402.
  9. International Institute for Population Sciences (IIPS) and Macro International. National Family Health Survey (NFHS-3), 2005-06. Vol. I. Mumbai: IIPS; 2007.
  10. Mallinson C, Bennett J, Hodgson P, Petros AJ. Position of the internal jugular vein in children. A study of the anatomy using ultrasonography. Paediatr Anaesth 1999;9:111-4.
  11. Sheridan RL, Weber JM. Mechanical and infectious complications of central venous cannulation in children: Lessons learned from a 10-year experience placing more than 1000 catheters. J Burn Care Res 2006;27:713-8.
  12. Melly MA, Meng HC, Schaffner W. Microbiol growth in lipid emulsions used in parenteral nutrition. Arch Surg 1975;110:1479-81.
  13. National Nosocomial Infections Surveillance (NNIS) System report, data summary from January 1990-May 1999, issued June 1999. Am J Infect Control 1999;27:520-32.
  14. Fridkin SK, Gaynes RP. Antimicrobial resistance in intensive care units. Clin Chest Med 1999;20:303-16.
  15. Raad II, Hohn DC, Gilbreath BJ, Suleiman N, Hill LA, Bruso PA, et al. Prevention of central venous catheter-related infections by using maximal sterile barrier precautions during insertion. Infect Control Hosp Epidemiol 1994;15:231-8.
  16. Miller MR, Griswold M, Harris JM 2 nd, Yenokyan G, Huskins WC, Moss M, et al. Decreasing PICU catheter-associated bloodstream infections: NACHRI′s quality transformation efforts. Pediatrics 2010;125:206-13.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.