{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T03:57:12Z","timestamp":1790913432154,"version":"4.1.0"},"reference-count":19,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,11,13]],"date-time":"2025-11-13T00:00:00Z","timestamp":1762992000000},"content-version":"vor","delay-in-days":316,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatrics International"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Central line\u2010associated bloodstream infections (CLABSIs) are the most common healthcare\u2010associated infections, leading to increased mortality, hospital stays, and costs. Despite evidence\u2010based prevention bundles, adherence is often suboptimal. This study aimed to evaluate the impact of a multimodal intervention on CLABSI rates in the pediatric intensive care unit (PICU), particularly in tertiary care settings with high infection rates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A quasi\u2010experimental study was conducted from September 2022 to March 2024, involving pediatric patients under 15\u2009years with central venous catheters (CVC). The multimodal intervention included guideline revisions, education, compliance monitoring, feedback, and reward. CLABSI rates during pre\u2010intervention, intervention, and post\u2010intervention phases were compared using a Poisson regression model and Kaplan\u2013Meier survival analysis. Cox proportional hazards models were used to assess risk factors for CLABSIs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 265 patients across three phases were included, with 3324 CVC days and a mean duration of 8.5\u2009days per central line. The intervention reduced CLABSI rates from 8.3 to 1.0 per 1000 catheter\u2010days during the intervention phase (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.049), with a rebound to 5.9 per 1000 catheter\u2010days post\u2010intervention. Kaplan\u2013Meier analysis demonstrated a statistically significant CLABSI incidence reduction in the intervention group versus the pre\u2010intervention group (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.011). Gram\u2010negative bacteria, predominantly\n                      <jats:italic>Acinetobacter baumannii<\/jats:italic>\n                      , were the leading pathogens (46.1%). Cox regression identified the multimodal intervention as a protective factor, with a hazard ratio of 0.27 (95% CI 0.18\u20130.39,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.005).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>A multimodal intervention significantly reduced CLABSI rates in the PICU, demonstrating the importance of comprehensive strategies in infection prevention. However, sustained compliance is essential to maintain these improvements.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ped.70252","type":"journal-article","created":{"date-parts":[[2025,11,13]],"date-time":"2025-11-13T16:18:16Z","timestamp":1763050696000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Multimodal intervention to decrease central line\u2010associated bloodstream infection rate in pediatric intensive care unit"],"prefix":"10.1111","volume":"67","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-4241-8861","authenticated-orcid":false,"given":"Soravee","family":"Subroongruang","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Faculty of Medicine Chulalongkorn University  Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Napaporn","family":"Chantasrisawad","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Faculty of Medicine Chulalongkorn University  Bangkok Thailand"},{"name":"Center of Excellence for Pediatric Infectious Diseases and Vaccines Chulalongkorn University  Bangkok Thailand"},{"name":"Thai Red Cross Emerging Infectious Diseases Clinical Center King Chulalongkorn Memorial Hospital The Thai Red Cross Society  Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lalida","family":"Kongkiattikul","sequence":"additional","affiliation":[{"name":"Division of Pediatric Pulmonology and Critical Care, Department of Pediatrics, Faculty of Medicine Chulalongkorn University  Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saowaluck","family":"Jaroenraviphak","sequence":"additional","affiliation":[{"name":"Nursing Department, King Chulalongkorn Memorial Hospital Thai Red Cross Society  Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Supranee","family":"Tarathumarat","sequence":"additional","affiliation":[{"name":"Nursing Department, King Chulalongkorn Memorial Hospital Thai Red Cross Society  Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kwanta","family":"Ngampring","sequence":"additional","affiliation":[{"name":"Infection and Prevention Control Unit, Nursing Department, King Chulalongkorn Memorial Hospital Thai Red Cross Society  Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wirada","family":"Horapong","sequence":"additional","affiliation":[{"name":"Infection and Prevention Control Unit, Nursing Department, King Chulalongkorn Memorial Hospital Thai Red Cross Society  Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6965-5537","authenticated-orcid":false,"given":"Suvaporn","family":"Anugulruengkitt","sequence":"additional","affiliation":[{"name":"Center of Excellence for Pediatric Infectious Diseases and Vaccines Chulalongkorn University  Bangkok Thailand"},{"name":"Division of Infectious Diseases, Department of Pediatrics, Faculty of Medicine Chulalongkorn University  Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,11,13]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jiph.2014.04.003"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jinf.2015.04.029"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra2213296"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1086\/662621"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/PCC.0b013e3181d90569"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2017.01.014"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2014.07.003"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(15)00409-0"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1017\/ice.2016.67"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjoq-2020-001200"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pedneo.2021.08.010"},{"key":"e_1_2_9_13_1","unstructured":"Centers for Disease Control and Prevention website.Bloodstream Infection Event (Central Line\u2010Associated Bloodstream Infection and Non\u2010central Line Associated Bloodstream Infection) [Internet].2025. 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