Changes in the incidence of Candida-related central line-associated bloodstream infections in pediatric intensive care unit: Could central line bundle have a role?

Candida species are among the most prevalent microorganisms in pediatric critical care units that cause central line-associated bloodstream infections. The goal of this study was to assess the therapeutic benefit of central line bundle for the prevention of Candida species-related bloodstream infections in pediatric intensive care units. The study covered the period from January 1, 2009, to December 31, 2019. Pre-bundle and bundle phases were included in the research. The Clinical Microbiology Laboratory's records revealed episodes of Candida-related central line-associated bloodstream infections. The study was conducted in the Dr. Behçet Uz Child Disease and Pediatric Surgery Training and Research Hospital's PICU (which has 24 beds and admits 350 patients per year). This study included pediatric patients in the pediatric intensive care unit with non-tunneled central venous catheters. In the pediatric intensive care unit, a central line bundle was started. A total of 236 Candida-related central line-associated bloodstream infections were discovered during the study period. Non-albicans Candida accounted for 83.5% (197) of the total, whereas C.albicans accounted for 16.5%(39). During the pre-bundle period, 137 Candida species were isolated from the patients, while 99 Candida species were isolated during the bundle period. Candida-related central line-associated bloodstream infections dropped from 13.68 to 5.93 per 1000 CL-days after the central line bundle was used (p < 0.001). According to our findings, the central line bundle greatly reduced central line-associated Candida species bloodstream infections. Central line bundles are an effective scientific solution for preventing Candida-related central line-associated bloodstream infections in hospitals with high Candida prevalence.

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Declaration of Competing Interest Ilker Devrim and Hasan Ağın had educational grant from BD. The other authors have no conflicts of interest to disclose.