การติดเชื้อและผลกระทบจากการติดเชื้อในกระแสโลหิตที่สัมพันธ์กับการใส่สายสวนหลอดเลือดของผู้ป่วยเด็กในโรงพยาบาลมหาวิทยาลัย

Abstract

Central line-associated bloodstream infection (CLABSI) has a serious impact on pediatric patients. This retrospective descriptive study aimed to investigate the incidence rate, distribution, and impacts of CLABSI in pediatric patients admitted to a university hospital by diagnosing the infection through symptoms and laboratory results. Data were obtained from medical records of pediatric patients with central venous catheter (CVC) insertions in the pediatric nursing division of 12 wards between January 1, 2017 and December 31, 2021. A total of 763 pediatric patient with CVC records were reviewed and identified following the Centers for Disease Control and Prevention (2017) definition of CLABSI by using the data collection form for CLABSI in pediatric patients and its impacts, which was developed by the researcher. Descriptive statistics were used for data analysis. The results revealed that CLABSI occurred 79 times in 57 pediatric patients; 59.65% were male, with ages ranging from 14 days to 18 years (x̄ = 2.64 years, S.D. = 4.64). Additionally, 59.65% of patients were newborn to 1 year old, 22.81% were 1-3 years old, and 8.77% were 13–18 years old. The incidence rates of CLABSI for each year, from 2017 to 2021, were 3.63, 1.64, 1.81, 2.58, and 3.46 per 1,000 central line days, respectively. The most common organism was Staphylococcus epidermidis (42.16%). The average duration of hospitalization was 116.53 days (range = 10-676, S.D. = 122.71). The case fatality rate of CLABSI in pediatric patients was 26.32%. The total cost of medical treatment for CLABSI was 1,339,253.12 baht with an average cost of 16,952.57 baht/infection (range = 2,452-159,176, S.D. = 18,166.71). The results of this study review the epidemiology of CLABSI in pediatric patients. Data from this study can be used to plan for prevention of CLABSI in hospitalized pediatric patients.