{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T23:07:57Z","timestamp":1777936077592,"version":"3.51.4"},"reference-count":32,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2021,6,21]],"date-time":"2021-06-21T00:00:00Z","timestamp":1624233600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Vasc Access"],"published-print":{"date-parts":[[2023,3]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Central line-associated bloodstream infections (CLABSI) are significant cause of complications in pediatric intensive care units (PICUs). An emerging challenge are CLABSIs in children with medical complexity (CMC) admitted to PICU. CMC are patients with chronic conditions with or without neurological impairment needing for tracheostomy and\/or home mechanical or non-invasive ventilation and\/or gastrostomy\/jejunostomy. We evaluate CLABSI incidence in a PICU with high prevalence of CMC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This was a retrospective study in the PICU of the Bambino Ges\u00f9 Children Hospital from January 2017 to December 2020. The medical records were reviewed and demographic, clinical and microbiological data were extracted. CLABSI were defined according to the Center for Disease Control and Prevention\u2019s National Healthcare Safety Networks (NHSN) surveillance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>A total of 101 children with 125 central lines (CLs) were included; 79\/101 (78%) patients were CMC and 50\/101 (50%) had a thracheostomy. CLABSI incidence was 2.75\/1000\u2009CL-days (9 cases\/3269\u2009CL-days); incidence was 0 in patients without underling conditions and 3.14\/1000 in CMC ( p\u2009&lt;\u20090.001). CLABSI were due to gram negative bacteria in five patients, Candida spp in three and Staphylococcus hominis in one. CLs were removed in eight cases while in the later one, with CLABSI due to Pseudomonas aeruginosa, a conservative strategy was adopted cause of unavailable alternative venous access and removed at discharge with negative culture. All patients recovered.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>A target 0% CLABSI was possible in critically ill children without underling condition while a high incidence was reported in CMC and sustained by a peculiar CLABSI ecology. This ecology should be considered when a CLABSI was suspected in CMC for prompt antibiotics stewardship.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/11297298211027468","type":"journal-article","created":{"date-parts":[[2021,6,21]],"date-time":"2021-06-21T03:14:40Z","timestamp":1624245280000},"page":"198-204","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["The burden of central line-associated bloodstream infections in children with medical complexity"],"prefix":"10.1177","volume":"24","author":[{"given":"Alessia","family":"Scarselli","sequence":"first","affiliation":[{"name":"Bambino Ges\u00f9 Pediatric Hospital, Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8947-4429","authenticated-orcid":false,"given":"Andrea","family":"Smarrazzo","sequence":"additional","affiliation":[{"name":"Bambino Ges\u00f9 Pediatric Hospital, Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesco","family":"De Sanctis","sequence":"additional","affiliation":[{"name":"Bambino Ges\u00f9 Pediatric Hospital, Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lucilla","family":"Rav\u00e0","sequence":"additional","affiliation":[{"name":"Bambino Ges\u00f9 Pediatric Hospital, Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3494-5753","authenticated-orcid":false,"given":"Michaela","family":"Carletti","sequence":"additional","affiliation":[{"name":"Bambino Ges\u00f9 Pediatric Hospital, Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marta","family":"Ciofi Degli Atti","sequence":"additional","affiliation":[{"name":"Bambino Ges\u00f9 Pediatric Hospital, Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcella","family":"Aversa","sequence":"additional","affiliation":[{"name":"Bambino Ges\u00f9 Pediatric Hospital, Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Riccardo","family":"Drago","sequence":"additional","affiliation":[{"name":"Bambino Ges\u00f9 Pediatric Hospital, Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2157-4233","authenticated-orcid":false,"given":"Alessandro","family":"Crocoli","sequence":"additional","affiliation":[{"name":"Bambino Ges\u00f9 Pediatric Hospital, Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Caterina","family":"Geremia","sequence":"additional","affiliation":[{"name":"Bambino Ges\u00f9 Pediatric Hospital, Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Guerricchio","sequence":"additional","affiliation":[{"name":"Bambino Ges\u00f9 Pediatric Hospital, Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Barbara","family":"Lucignano","sequence":"additional","affiliation":[{"name":"Bambino Ges\u00f9 Pediatric Hospital, Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Campana","sequence":"additional","affiliation":[{"name":"Bambino Ges\u00f9 Pediatric Hospital, Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Antonietta","family":"De Ioris","sequence":"additional","affiliation":[{"name":"Bambino Ges\u00f9 Pediatric Hospital, Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniela","family":"Perrotta","sequence":"additional","affiliation":[{"name":"Bambino Ges\u00f9 Pediatric Hospital, Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2021,6,21]]},"reference":[{"key":"bibr1-11297298211027468","doi-asserted-by":"publisher","DOI":"10.1186\/cc12730"},{"key":"bibr2-11297298211027468","doi-asserted-by":"publisher","DOI":"10.1086\/657912"},{"key":"bibr3-11297298211027468","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2009-1658"},{"key":"bibr4-11297298211027468","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2010-0910"},{"key":"bibr5-11297298211027468","volume-title":"The GAVeCeLT manual of Picc and midline: indications, insertion, management","author":"Pittiruti M"},{"key":"bibr6-11297298211027468","unstructured":"https:\/\/www.cdc.gov\/infectioncontrol\/guidelines\/bsi\/index.html (accessed 29 April 2020)."},{"key":"bibr7-11297298211027468","doi-asserted-by":"publisher","DOI":"10.1001\/jama.297.24.2741"},{"key":"bibr8-11297298211027468","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2005-2070"},{"key":"bibr9-11297298211027468","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2214.2001.00187.x"},{"key":"bibr10-11297298211027468","doi-asserted-by":"publisher","DOI":"10.5301\/jva.5000727"},{"key":"bibr11-11297298211027468","unstructured":"European Centre for Disease Control and Prevention. 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