Targeting zero catheter-related bloodstream infections in pediatric intensive care unit: a retrospective matched case-control study:

Introduction:The aim of this study was to evaluate the effectiveness and safety of a new three-component ‘bundle’ for insertion and management of centrally inserted central catheters (CICCs), designed to minimize catheter-related bloodstream infections (CRBSIs) in critically ill children.Methods:Our ‘bundle’ has three components: insertion, management, and education. Insertion and management recommendations include: skin antisepsis with 2% chlorhexidine; maximal barrier precautions; ultrasound-guided venipuncture; tunneling of the catheter when a long indwelling time is expected; glue on the exit site; sutureless securement; use of transparent dressing; chlorhexidine sponge dressing on the 7th day; neutral displacement needle-free connectors. All CICCs were inserted by appropriately trained physicians proficient in a standardized simulation training program.Results:We compared CRBSI rate per 1000 catheters-days of CICCs inserted before adoption of our new bundle with that of CICCs inserted after implement...