Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Pediatrics

Catheter-related bloodstream infection (CRBSI) is a significant source of morbidity, mortality and healthcare cost in NICU as inadequate insertion and maintenance may contribute to an increased risk of infections. Objective: Detection rate and pattern of CRBSI and catheter colonization in NICU, ability of staphylococci and Candida to form vascular catheter biofilm leading to blood stream infection. Subjects and methods: Prospective observational study included 100 newborns admitted to NICU at Cairo University Children Hospital (CUCH) had central vascular catheters and developed signs of sepsis 48 hours after insertion or after removal without another cause of sepsis and for each neonate vascular catheter tips and peripheral blood sample were collected. Vascular catheter tips were cultured using the semi quantitative culture method, the blood samples were used for blood culture and isolated staphylococci and candida were tested for biofilm by both Congo red agar plate method and tube method respectively. Results: Out of 100 patients, 12(12%) were CRBSI. klebsiella species were the predominant microorganisms (7/12). Isolated organisms in CRBSI were multi to extended drug resistant as 5 of them were sensitive only to polymyxin. The mortality rate was 75% between CRBSI. 2(2%) biofilms only were detected, one for staphylococcus aurous and one for Candida. 48 (48%) catheter tips were positive for colonization. The increased number of attempts at insertion was the only predictor for colonization (P<0.05). Conclusions: CRBSI recorded significantly high mortality in our NICU and caused mainly by gram negative organisms which were multi to extended drug resistant in the majority.

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