Arterial catheter-related infections in children. A 1-year cohort analysis
S. Furfaro, M. Gauthier, J. Lacroix, D. Nadeau, L. Lafleur and S. Mathews
Department of Pediatrics, St-Justine Hospital, University of Montreal, Quebec, Canada.
To determine the incidence of infection secondary to arterial
catheterization in children as well as the risk markers, we prospectively
evaluated, during a 1-year period, all arterial catheters installed in
children admitted to the pediatric intensive care unit. A total of 340
cannulas were placed in 310 children aged 80 +/- 4 months (mean +/- SEM)
for a period of 64 +/- 4 hours. Most catheters were inserted percutaneously
(99%) in the radial artery (86.5%). Ninety-two percent (313/340) of the
catheters were sterile (group 1), 5% (17/340) were contaminated (less than
10 colony-forming units on semiquantitative culture) (group 2), and 3%
(10/340) were considered either locally infected (ie, greater than or equal
to 10 colony-forming units) (eight of 10) or associated with a possible
catheter-related sepsis (two of 10) (group 3, or infected group). The
incidence of local inflammation at the insertion site was higher in group 2
than in group 1 (18% vs 2.9%) but not statistically different between
groups 3 and 1 (10% vs 2.9%). The duration of arterial catheterization was
longer in group 3 than in group 1 (125 +/- 31 vs 61 +/- 4 hours). The risk
of infection was nonexistent in the first 48 hours of catheterization.
Thereafter it was calculated as being 6.2% (10/161), but it correlated
poorly with the duration of arterial catheterization. These results confirm
the very low incidence of infection related to arterial catheterization in
children. Thus, routine catheter reinsertion is, in our opinion,
unjustified.
