Epidemiology of central line-associated bloodstream infections in the pediatric intensive care unit

Objective. Describe central line–associated bloodstream infection (CLA-BSI) epidemiology in pediatric intensive care units (PICUs).Design. Descriptive study (29 PICUs); cohort study (18 PICUs).Setting. PICUs in a national improvement collaborative.Patients/participants. Patients admitted October 2006 to December 2007 with 1 or more central lines.Methods. CLA-BSIs were prospectively identified using the National Healthcare Safety Network definition and then readjudicated using the revised 2008 definition. Risk factors for CLA-BSI were examined using age-adjusted, time-varying Cox proportional hazards models.Results. In the descriptive study, the CLA-BSI incidence was 3.1/1,000 central line–days; readjudication with the revised definition resulted in a 17% decrease. In the cohort study, the readjudicated incidence was 2.0/1,000 central line–days. Ninety-nine percent of patients were CLA-BSI-free through day 7, after which the daily risk of CLA-BSI doubled to 0.27% per day. Compared with patients with respir...