الفهرس 
? Neonatal sepsis and Central Line Associated Blood Stream InfectionOnly 14 pages are availabe for public view
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Abstract
Central-line–associated bloodstream infections (CLABSIs) are a major source of healthcare-associated infections in neonatal intensive care units (NICUs), and they are associated with increased morbidity, mortality.
Aim: To implement care bundles and evaluate their efficacy in reducing CLABSI in the NICU-children hospital- Ain Shams university.
Patients and methods: Interventional study was carried out over 9 months duration: the pre-bundle period was 5 months in duration and the post-bundle period was 4 months, surveillance of CLABSI rate in the pre-bundle period and after implementation of care bundles in the post-bundle period was done through two blood cultures samples were taken from each patient thought to be infected based on clinical signs suggestive of infection (apnea, bradycardia, bad perfusion, temperature instability) and laboratory markers like C-reactive protein (CRP) with one culture sample from CVC and the other from a peripheral vein, CLABSI was diagnosed according to Centers for Disease Control and Prevention (CDC) criteria.
Results: Care bundles successfully decreased CLABSI rates from 31.19/1000 device days to 11.88/1000 device days (p value =0.026). No statistically significant differences between CLABSI cases and others with no CLABSI as regards demographic characteristics. The use of invasive respiratory support was significantly associated with a high rate of CLABSI episodes. Catheter indwell time > 8 days was significantly associated with CLABSI, CLABSI was significantly associated with prolonged hospitalization with a median of 18(12-25) days. Klebsiella was the most common isolated organism among CLABSI cases with a percentage of 52.1 %. The percentage of mortality was 56.5% among CLABSI cases.
Conclusions: Implementation of central line bundle programs, including insertion and maintenance bundles effectively reduced CLABSI in NICUs.