S1 |
Hruszkewycz et al./USA |
Case-control |
263 neonates |
1989 |
To assess the incidence and spectrum of complications associated with central venous catheter (CVC) placement in severely ill neonates. |
Five infants (29%) developed six episodes of bloodstream infection. Infants with CVC-related infection had lower gestational age (24 weeks vs. 32 weeks, p = 0.04) and lower birth weight (580 g vs. 1285 g, p = 0.02). The overall bloodstream infection rate was one episode per 100 days of catheter use. |
S2 |
Sengupta A, Lehmann C, Diener-West M, Perl TM, Milstone AM/USA |
Retrospective cohort |
683 neonates |
2006-2008 |
To determine risk factors for CVC-BSI during PICC use in high-risk newborns. |
The duration of catheter use is a risk factor for CVC-BSI (IRR: 1.33 [95% CI: 1.12-1.57]). There was a significant daily increase in the risk of CVC-BSI after 35 days. |
S3 |
Jen-Fu Hsu, Ming-Horng Tsai, Hsuan-Rong Huang, Reyin Lien, Shih-Ming Chu, Chung-Bin Huang Risk/Taiwan |
Retrospective cohort |
275 neonates |
2005-2006 |
To verify the risk of infection and other complications associated with PICC in very low-birth weight neonates. |
Significant risk factors for CVC-BSI: femoral catheters (increased risk of CVC-BSI compared to non-femoral catheters: (OR 1.76, 95% CI: 1.01-3.07, p = 0.045) and longer time of PICC use: (RR 4.66, 95% CI: 1.93-11.28; p < 0.001)). |
S4 |
Ohki Y, Maruyama K, Harigaya A, Kohno M, Arakawa H/Japan |
Multicenter prospective cohort |
946 neonates/19 NICUs |
2005-2007 |
To investigate the incidence and risk factors for PICC-related complications using a multicenter survey. |
Multiple logistic regression analysis showed that longer catheter use (OR, 1.35, 95% CI: 1.14-1.60, p = 0.0005) independently contributed to overall complications. |
S5 |
Milstone AM, Reich NG, Advani S, et al./USA |
Multicenter retrospective cohort |
3967 neonates/nine NICUs |
2005-2009 |
To determine the association of risk of CVC-associated bloodstream infections during the time of permanence of peripherally-inserted central catheters (PICCs) in high-risk newborns. |
PICCs with a time of use of 8-13 days, from 14 to 22 days, and those ≥23 days each had an increased risk of infection compared to PICCs that remained ≤7 days (p < 0.05). There was an increased risk of CVC-BSI in neonates with PICCs (adjusted incidence rate ratio of 2.04, 1.12-3.71). |
S6 |
Greenberg RG et al./USA3434 Greenberg RG, Cochran KM, Smith PB, Edson BS, Schulman J, Lee HC, et al. Effect of catheter dwell time on risk of central line-associated bloodstream infection in infants. Pediatrics. 2015;136:1080-6.
|
Multicenter retrospective cohort |
13,327 neonates/141 NICUs |
2011-2013 |
To test the hypothesis that a longer CVC time of use is associated with a higher incidence of CVC-BSI. |
Mean gestational age was 29 weeks (interquartile range: 26-33). The incidence of CVC-BSI was 0.93 per 1000 CVC-day. The longer time of device use was not associated with an increased risk of BSI for PICC. For long-term catheters, the incidence of infection was significantly higher at week seven (HR 4.0; 95% CI: 1.1-15, p < 0.004) and week nine (HR 4.7; 1.1-20 p < 0.003) compared to week one. |
S7 |
Yumani DF, van den Dungen FA, van Weissenbruch MM/The Netherlands3535 Yumani DF, van den Dungen FA, van Weissenbruch MM. Incidence and risk factors for catheter-associated bloodstream infections in neonatal intensive care. Acta Paediatr. 2013;102:e293-8.
|
Retrospective cohort |
196 neonates |
2007 |
To determine the incidence and potential risk factors for catheter-associated bloodstream infections in newborns. |
18.1 infections/1000 CVC-day (95% CI: 13.7-23.8) according to the adjusted criteria used by the CDC before 2008. Umbilical catheters had a higher infection rate than non-umbilical central catheters (rate ratio = 2.4; 95% CI: 1.2-4, <0.0009), and if it remained for more than five days, the infection rate increased (p < 0.05). |
S8 |
Duarte ED, Pimenta AM, Silva BCNe, Paula CMd./Brazil3636 Duarte ED, Pimenta AM, Silva BC, Paula CM. Fatores associados à infecção pelo uso do cateter central de inserção periférica em unidade de terapia intensiva neonatal. Rev Esc Enferm USP. 2013;47:547-54.
|
Prospective cohort |
233 newborns |
2010 |
To analyze the factors related to infection associated with the use of peripherally-inserted central catheters in neonates admitted at an intensive care unit. |
Factors associated with removal due to infection suspicion after multivariate adjustment were: weight < 2500 g at the insertion (RR 1.99; 95% CI: 1.06-3.73, p = 0.031), repair (RR 2.3; 95% CI: 1.08-4.89, p = 0.030); and time of catheter use (RR 1.04; 95% CI: 1.02-1.06, p < 0.0000). |
S9 |
Barbosa MH et al./Brazil3737 Barbosa M, Figueiredo V, Wernet M, Pires P. Infecção de corrente sanguínea relacionada ao uso de cateteres venosos centrais em recém-nascidos. Nursing. 2009;11:82-6.
|
Retrospective cohort |
18 neonates |
2005 |
To analyze the risk factors associated with the occurrence of central venous catheter-associated bloodstream infections in newborns admitted at a neonatal intensive care unit (NICU). |
Low birth weight, prematurity, and the use of TPN may have influenced the occurrence of infection. |
S10 |
Shalabi M et al./Canada |
Prospective cohort |
7919/29 NICU |
2010-2013 |
To compare CVC-BSI rates in preterm infants born at <30 weeks gestation who received a PICC vs. umbilical venous catheter immediately after birth as primary venous access. |
There was no significant difference in infants with CVC-BSI/1000 CVC-day between the evaluated groups, although lower rates of late sepsis in the group of infants who received only one umbilical catheter were observed. There was an increase in episodes of late sepsis/1000 CVC-day in the PICC group compared to neonates who had an umbilical catheter and PICC (RR 1.73; 95% CI: 1.15-2.60, p < 0.001). |
S11 |
Bellemin K et al./France |
Retrospective cohort |
1111/three NICUs |
2007-2011 |
To evaluate incidence and risk factors for CVC-BSI. |
The incidence density was 16/1000 CVC-day (95% CI: 14.0-18.2): 6.5 (95% CI: 4.3-9.3) for umbilical CVC and 20.2 (95% CI: 5-23.1) for other CVCs. The median time to CVC-BSI was eight days. In the multivariate analysis, birth weight ≤ 750 g (HR 6.3, 95% CI: 1.0-38.1) and intravenous lipid emulsion (HR 2.3, 95% CI: 1.3-3.9) were significantly associated with CVC-BSI for umbilical CVC. Similar results were observed for other CVCs. |
S12 |
Costa P et al./Brazil |
Prospective cohort |
383 |
2010-2012 |
Identify the risk factors for PICC-associated bloodstream infection in neonates. |
In the bivariate analysis, lower mean weight and corrected gestational age, and longer catheter use were associated with the occurrence of CVC-BSI. In the multivariate analysis, corrected gestational age (RR 1.12; 95% CI: 1.061-1.186, p < 0.002), transient metabolic disorder (RR 3.02; 95% CI: 1.72-5.05, p < 0.000), apnea (RR 2.38; 95% CI: 1.10-4.56, p < 0.016), and two-way and polyurethane catheters (RR 3.70; 95% CI: 2.0-6.9, p < 0.0000) were associated with CVC-BSI. |
S13 |
Geffers C, Gastmeier A, Schwab F, Groneberg K, Ruden H, Gastmeier P/Germany4141 Geffers C, Gastmeier A, Schwab F, Groneberg K, Ruden H, Gastmeier P. Use of central venous catheter and peripheral venous catheter as risk factors for nosocomial bloodstream infection in very-low-birth-weight infants. Infect Control Hosp Epidemiol. 2010;31:395-401.
|
Multicenter prospective cohort |
2126 neonates/22 NICUs |
2010 |
To describe the association between CVC and peripherally-inserted central catheter use and the risk of laboratory-confirmed BSI for newborns with birth weight <1500 g. |
The incidence density for BSI was 3.3/1000 patient-days. The use of a central venous catheter (HR 6.2; 95% CI: 3.83-9.97, p < 0.001) was one of the independent significant factors for BSI. |
S14 |
Padula et al./USA4242 Padula MA, Dewan ML, Shah SS, Padula AM, Srinivasan L, McGowan KL, et al. Risk factors associated with laboratory-confirmed bloodstream infections in a tertiary neonatal intensive care unit. Pediatr Infect Dis J. 2014;33:1027-32.
|
Prospective cohort |
409 neonates |
2006-2009 |
To determine the clinical signs and risk factors associated with laboratory-confirmed BSI in patients assessed for late sepsis in a tertiary NICU. |
Use of enteral contrast within the previous 48 h was the most significant risk factor for laboratory-confirmed BSI [OR: 9.58 (95% CI: 2.03-45.19)], followed by the presence of a central venous catheter. |