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Vol. 15. Issue 6.
Pages 573-577 (November - December 2011)
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Vol. 15. Issue 6.
Pages 573-577 (November - December 2011)
Original article
Open Access
Preventing catheter-associated infections in the Pediatric Intensive Care Unit: Impact of an educational program surveying policies for insertion and care of central venous catheters in a Brazilian teaching hospital
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Marcelo Luiz Abramczyk1,
Corresponding author
mabramczyk@ig.com.br

Correspondence to: Marcelo Luiz Abramczyk Rua Napoleão de Barros, 690/2° – Vila Clementino 04024-062 São Paulo, SP Brazil.
, Werter B. Carvalho2, Eduardo A.S. Medeiros3
1 Infectious Disease Pediatric Department, Universidade Federal de São Paulo (UNIFESP), SP, Brazil
2 Pediatrics Department, Pediatric Intensive Care Unit, Universidade de São Paulo (USP), SP, Brazil
3 Hospital Infection Program, Division of Infectious Diseases, UNIFESP, SP, Brazil
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Abstract
Objectives

To determine the impact of an educational program on the prevention of central venous catheter-related infections in a Brazilian Pediatric Intensive Care Unit.

Patients and Methods

All patients admitted to the unit between February 2004 and May 2005 were included in the cohort study in a longitudinal assessment. An educational program was developed based on the Centers for Disease Control and Prevention recommendations for prevention of catheter-associated infections and was adapted to local conditions and resources after an initial observational phase. Incidence of catheter-associated infections was measured by means of on-site surveillance.

Results

One hundred eighteen nosocomial infections occurred in 253 patients (46.6 infections per 100 admissions) and in 2,954 patient-days (39.9 infections per 1,000 patient-days). The incidence-density of catheter infections was 31.1 episodes per 1.000 venous central catheter-days before interventions, and 16.5 episodes per 1,000 venous central catheter-days afterwards (relative risk 0.53 [95% CI 0.28–1.01]). Corresponding rates for exit-site catheter infections were 8.0 and 2.5 episodes per 1,000 venous central catheter-days [0.32 (0.07–1.49)], and the rates for bloodstream infections were 23.1 and 13.9 episodes per 1,000 venous central catheter-days, before and after interventions [0.61 (0.32–1.14)].

Conclusion

A prevention strategy targeted at the insertion and maintenance of vascular access can decrease rates of vascular-access infections in pediatric intensive care unit.

Keywords:
catheterization, central venous
Intensive care units
Pediatric disease prevention
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