Septicemias associated with central venous catheterization in a children'shospital. Multivariate study

BACKGROUND: The blood stream infections (BSI) are the principal nosocomial infection in the child hospitals. In this study we estimate the incidence o f BSI associated with central venous catheterization, and estimate differen t risk and protective factors, through a multivariate study. MATERIAL AND METHODS: The study have followed in a prospective way during 6 months all the children with central venous catheterization (489 catheters ), from the moment of insertion until withdrawal, collecting various data p revious to the development of the infection: place of insert, type of cathe ter, duration, clinic information, microbiology, and the treatments adminis tered through the catheter, It was accomplished an multivariate analysis wi th logistic regression, for two principal effect variables, the catheter co lonization and the catheter related BSI. RESULTS: The incidence of catheter related BSI was 5.5% and for local infec tion 11.2%. The density of incidence was 3.15 and 6.42 for each 1,000 cathe ters-day, respectively. The logistic regression model included: colonizatio n of the skin in the insertion paint > 15 colonies, days with antibiotics t hrough catheter, use of lipidic parenteral solutions and fever, previous to the infection. The area under the ROC curve was 0.72. CONCLUSIONS: In children with septicemias associated with central catheteri zation the predictors or sentry criterion far the decision on when to withd raw a catheter are colonization (> 15 colonies) of the insert point. togeth er with the use of lipidic parenteral solutions or extended antibiotic trea tment.