Abstract
Background
Central line-associated bloodstream infections (CLABSI) are a main focus of infection prevention and control initiatives in neonatal care. Standardised surveillance of neonatal CLABSI enables intra- and interfacility comparisons which can contribute to quality improvement. To date, there is no national registration system for CLABSI in neonatal care in the Netherlands and several criteria are used for local monitoring of CLABSI incidence rates. To achieve standardised CLABSI surveillance we conducted a consensus procedure with regard to nationwide neonatal CLABSI surveillance criteria (SC).
Methods
A modified Delphi consensus procedure for the development of nationwide neonatal CLABSI SC was performed between January 2016 and January 2017 in the Netherlands. An expert panel was formed by members of the Working Group on Neonatal Infectious Diseases of the Section of Neonatology of the Dutch Paediatric Society. The consensus procedure consisted of three expert panel rounds.
Results
The expert panel achieved consensus on Dutch neonatal CLABSI SC. Neonatal CLABSI is defined as a bloodstream infection occurring more than 72 h after birth, associated with an indwelling central venous or arterial line and laboratory confirmed by one or more blood cultures. In addition, the blood culture finding should not be related to an infection at another site and one of the following criteria can be applied: 1. a bacterial or fungal pathogen is identified from one or more blood cultures; 2. the patient has clinical symptoms of sepsis and 2A) a common commensal is identified in two separate blood cultures or 2B) a common commensal is identified by one blood culture and C-reactive protein level is above 10 mg/L in the first 36 h following blood culture collection.
Conclusions
The newly developed Dutch neonatal CLABSI SC are concise, specified to the neonatal population and comply with a single blood culture policy in actual neonatal clinical practice. International agreement upon neonatal CLABSI SC is needed to identify best practices for infection prevention and control.
Central line-associated bloodstream infections (CLABSI) are a main focus of infection prevention and control initiatives in neonatal care. Standardised surveillance of neonatal CLABSI enables intra- and interfacility comparisons which can contribute to quality improvement. To date, there is no national registration system for CLABSI in neonatal care in the Netherlands and several criteria are used for local monitoring of CLABSI incidence rates. To achieve standardised CLABSI surveillance we conducted a consensus procedure with regard to nationwide neonatal CLABSI surveillance criteria (SC).
Methods
A modified Delphi consensus procedure for the development of nationwide neonatal CLABSI SC was performed between January 2016 and January 2017 in the Netherlands. An expert panel was formed by members of the Working Group on Neonatal Infectious Diseases of the Section of Neonatology of the Dutch Paediatric Society. The consensus procedure consisted of three expert panel rounds.
Results
The expert panel achieved consensus on Dutch neonatal CLABSI SC. Neonatal CLABSI is defined as a bloodstream infection occurring more than 72 h after birth, associated with an indwelling central venous or arterial line and laboratory confirmed by one or more blood cultures. In addition, the blood culture finding should not be related to an infection at another site and one of the following criteria can be applied: 1. a bacterial or fungal pathogen is identified from one or more blood cultures; 2. the patient has clinical symptoms of sepsis and 2A) a common commensal is identified in two separate blood cultures or 2B) a common commensal is identified by one blood culture and C-reactive protein level is above 10 mg/L in the first 36 h following blood culture collection.
Conclusions
The newly developed Dutch neonatal CLABSI SC are concise, specified to the neonatal population and comply with a single blood culture policy in actual neonatal clinical practice. International agreement upon neonatal CLABSI SC is needed to identify best practices for infection prevention and control.
| Original language | English |
|---|---|
| Article number | 31 |
| Number of pages | 8 |
| Journal | Antimicrobial Resistance and Infection Control |
| Volume | 10 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - Dec 2021 |
Bibliographical note
Funding Information:I.G. Hauth is acknowledged for the language editing. Involved members of the Working Group on Neonatal Infectious Diseases of The Section of Neonatology of the Dutch Paediatric Society: R.F. Kornelisse, Department of Pediatrics, Division of Neonatology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands E.J. d’ Haens, Department of Neonatology, Isala Women and Children's Hospital Zwolle, Zwolle, the Netherlands. M.A.C. Hemels, Department of Neonatology, Isala Women and Children's Hospital Zwolle, Zwolle, the Netherlands. J.U.M. Termote, Department of Neonatology, Wilhelmina Children's Hospital Birth Center, University Medical Center Utrecht, Utrecht, The Netherlands V. Bekker, Department of Pediatrics, Division of Neonatology, Willem Alexander Children’s Hospital, Leiden University Medical Center (LUMC), Leiden, The Netherlands S.J. Jansen, Department of Pediatrics, Division of Neonatology, Willem Alexander Children’s Hospital, Leiden University Medical Center (LUMC), Leiden, The Netherlands D.H. Visser, Department of Neonatology, Emma Children's Hospital, Amsterdam UMC, Academic Medical Center, 1105 AZ, Amsterdam, The Netherlands J.P.F. van der Sluijs-Bens, Department of Pediatrics, Division of Neonatology, Máxima Medical Center, Veldhoven, The Netherlands M.C. Hutten, Department of Pediatrics, Division of Neonatology, Maastricht University Medical Center (Maastricht UMC+), Maastricht, The Netherlands K.A. Bergman, Department of Pediatrics, Division of Neonatology, University Medical Center Groningen, Groningen, The Netherlands
Publisher Copyright:
© 2021, The Author(s).
