{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T20:18:52Z","timestamp":1760300332446,"version":"3.40.5"},"reference-count":29,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2020,1,15]],"date-time":"2020-01-15T00:00:00Z","timestamp":1579046400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Paediatrics Child Health"],"published-print":{"date-parts":[[2020,6]]},"abstract":"<jats:sec><jats:title>Aim<\/jats:title><jats:p>The aims of the study are to evaluate the impact of a 4% chlorhexidine (CHG4%) bathing on the occurrence of central\u2010line\u2010associated bloodstream infection (CLABSI) and to identify risk factors (RFs) for CLABSI in our population. This is a retrospective monocentric cohort study in the paediatric surgical intensive care unit at the Necker Enfants Malades Hospital, Paris, France.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>All hospitalised patients with central venous catheters (CVCs) in 2015 were included. CHG4% bathing was prescribed in CLABSI high\u2010risk patients, defined by the presence of exposition factors (EFs): constitutive or acquired immunosuppression, presence of an invasive medical device (IMD) and the carriage of <jats:styled-content style=\"fixed-case\"><jats:italic>Staphylococcus aureus<\/jats:italic><\/jats:styled-content>. The overall 2015 CLABSI incidence rate was compared with 2014 CLABSI incidence rate (before CHG4% bathing).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In all, 775 patients were analysed. Some 182 had at least one EF, and 49 received CHG4%. The incidence rates of CLABSI in 2014 and 2015 were, respectively, 6.1 and 2.3\/1000\u2009days CVC (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.01). The presence of at least one EF was associated with the CLABSI's occurrence: odds ratio = 15.13 (95% confidence interval: 4.26\u201353.71; <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.0001), particularly acquired immunosuppression, IMD and <jats:italic>S. aureus<\/jats:italic> colonisation. Other RFs were age\u2009&lt;1 year and carrying duration &gt;16\u2009days.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This study showed a significant reduction in incidence of CLABSI after introduction of a targeted CHG4% bathing protocol. Presence of IMD, <jats:styled-content style=\"fixed-case\"><jats:italic>S. aureus<\/jats:italic><\/jats:styled-content> colonisation, immunosuppression, age\u2009&lt;1 year and carrying duration &gt;16\u2009days were CLABSI RFs. Regarding the literature, the presence of IMD seems to be underestimated in CLABSI prevention.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jpc.14780","type":"journal-article","created":{"date-parts":[[2020,1,15]],"date-time":"2020-01-15T09:45:47Z","timestamp":1579081547000},"page":"936-942","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Central\u2010line\u2010associated bloodstream infections in a surgical paediatric intensive care unit: Risk factors and prevention with chlorhexidine bathing"],"prefix":"10.1111","volume":"56","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5477-6021","authenticated-orcid":false,"given":"Thibault","family":"Martinez","sequence":"first","affiliation":[{"name":"Surgical Pediatric Intensive Care Unit Universitary Hospital Necker Enfants Malades  Paris France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Baugnon","sequence":"additional","affiliation":[{"name":"Surgical Pediatric Intensive Care Unit Universitary Hospital Necker Enfants Malades  Paris France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Estelle","family":"Vergnaud","sequence":"additional","affiliation":[{"name":"Surgical Pediatric Intensive Care Unit Universitary Hospital Necker Enfants Malades  Paris France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Caroline","family":"Duracher","sequence":"additional","affiliation":[{"name":"Surgical Pediatric Intensive Care Unit Universitary Hospital Necker Enfants Malades  Paris France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anne C","family":"Perie","sequence":"additional","affiliation":[{"name":"Surgical Pediatric Intensive Care Unit Universitary Hospital Necker Enfants Malades  Paris France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Olivier","family":"Bustarret","sequence":"additional","affiliation":[{"name":"Surgical Pediatric Intensive Care Unit Universitary Hospital Necker Enfants Malades  Paris France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Myriam","family":"Jugie","sequence":"additional","affiliation":[{"name":"Surgical Pediatric Intensive Care Unit Universitary Hospital Necker Enfants Malades  Paris France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert","family":"Rubinsztajn","sequence":"additional","affiliation":[{"name":"Surgical Pediatric Intensive Care Unit Universitary Hospital Necker Enfants Malades  Paris France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pierre","family":"Frange","sequence":"additional","affiliation":[{"name":"Hospital Infection Control Team Universitary Hospital Necker Enfants Malades  Paris France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philippe","family":"Meyer","sequence":"additional","affiliation":[{"name":"Surgical Pediatric Intensive Care Unit Universitary Hospital Necker Enfants Malades  Paris France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gilles","family":"Orliaguet","sequence":"additional","affiliation":[{"name":"Surgical Pediatric Intensive Care Unit Universitary Hospital Necker Enfants Malades  Paris France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"St\u00e9phane","family":"Blanot","sequence":"additional","affiliation":[{"name":"Surgical Pediatric Intensive Care Unit Universitary Hospital Necker Enfants Malades  Paris France"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,1,15]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2013.9763"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2016.08.007"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1086\/657912"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cir257"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1113849"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)61687-0"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1624-0693(03)00051-3"},{"volume-title":"Management of Intra\u2010Vascular Lines in Intensive Care Unit \u2013 Recommandations formalis\u00e9es d'experts gestion des abords vasculaires en r\u00e9animation RFE","year":"2019","author":"Timsit AJ","key":"e_1_2_6_9_1"},{"key":"e_1_2_6_10_1","unstructured":"Comit\u00e9 technique des infections nosocomiales et des infections li\u00e9es aux soins. 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