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ORIGINAL RESEARCH article

Front. Microbiol.
Sec. Infectious Agents and Disease
Volume 15 - 2024 | doi: 10.3389/fmicb.2024.1495568

Infusion Line contamination in Preterm Neonates : Impact of Infusion Line Design, Length, and Use Duration: the Multicenter ChronoBIOline Study

Provisionally accepted
Sandra Dos Santos Borges Sandra Dos Santos Borges 1Anne-Sophie VALENTIN Anne-Sophie VALENTIN 1Mathilde Farizon Mathilde Farizon 1Manon Charbonneau Manon Charbonneau 1Riadh Mohamed Boukhris Riadh Mohamed Boukhris 2Roselyne Brat Roselyne Brat 3Fabiana Cazzorla Fabiana Cazzorla 4Jennifer Chauvel Jennifer Chauvel 5Fabrice Cneude Fabrice Cneude 6Pauline Coutable Pauline Coutable 7Maryvonne Demasure Maryvonne Demasure 8Emeline Duminil Emeline Duminil 9Véronique Faraut-Derouin Véronique Faraut-Derouin 10Maud Gits-Muselli Maud Gits-Muselli 11Valérie Gorin Valérie Gorin 8Rosemary Goujon Rosemary Goujon 5Mélinda Guillouche-Puissant Mélinda Guillouche-Puissant 12Nadine Hacinlioglu Nadine Hacinlioglu 12Caroline Landelle Caroline Landelle 4Annick Lefebvre Annick Lefebvre 13Elise Leroy-Terquem Elise Leroy-Terquem 14Aurore Martinet Aurore Martinet 3Camille Massebeuf Camille Massebeuf 4Nadia Mazille-Orfanos Nadia Mazille-Orfanos 12Guillaume Ménard Guillaume Ménard 15Laure Menvielle Laure Menvielle 16Vanessa Monin Vanessa Monin 17Virginie Morange Virginie Morange 18Juliana Patkai Juliana Patkai 19Nathalie Perrault Nathalie Perrault 20Emilie Prat Emilie Prat 21Nathalie Laure van der Mee-Marquet Nathalie Laure van der Mee-Marquet 1*
  • 1 Hôpital Bretonneau, Centre d'Appui pour la Prévention des Infections Associées aux Soins (CPIAS) Centre - val de Loire, Centre Hospitalier Universitaire de Tours, Tours, France
  • 2 Service de réanimation néonatale, Centre Hospitalier Universitaire, Lille, France, Lille, France
  • 3 Service de réanimation néonatale, Centre Hospitalier Universitaire, Orléans, France
  • 4 Equipe opérationnelle d'hygiène, Centre Hospitalier Universitaire,, Grenoble, Rhône-Alpes, France
  • 5 Service de néonatalogie, Centre Hospitalier, Saint Brieuc, France
  • 6 Service de réanimation néonatale, Centre Hospitalier Universitaire, Grenoble, Rhône-Alpes, France
  • 7 Service de réanimation néonatale, Centre Hospitalier Universitaire, Tours, France
  • 8 Service de Prévention du Risque Infectieux, Centre Hospitalier Régional d'Orléans, Orléans, France
  • 9 Equipe opérationnelle d'hygiène, Centre Hospitalier, Calais, France
  • 10 Equipe opérationnelle d'hygiène, Assistance Publique - Hôpitaux de Paris, Hôpital Cochin, Paris, France
  • 11 Equipe opérationnelle d'hygiène, Assistance Publique - Hôpitaux de paris, Hôpital Robert Debré, Paris, France
  • 12 Service de réanimation néonatale, Centre Hospitalier Universitaire, Rennes, France
  • 13 Equipe opérationnelle d'hygiène, Centre Hospitalier universitaire, Reims, France
  • 14 Service de réanimation néonatale, Assistance Publique - Hôpitaux de Paris, Hôpital Necker, Paris, France
  • 15 Service de bactériologie et hygiène hospitalière, Centre Hospitalier Universitaire, Rennes, France
  • 16 Service de réanimation néonatale et pédiatrique, Centre Hospitalier Universitaire, Reims, France
  • 17 Service de réanimation néonatale, Assistance Publique - Hôpitaux de Paris, Hôpital Béclère, Clamart, France
  • 18 Equipe opérationnelle d'hygiène, Centre Hospitalier Universitaire, Tours, France
  • 19 Service de réanimation, Assistance Publique - Hôpitaux de Paris, Hôpital Port-Royal, Paris, France
  • 20 Service de réanimation néonatale, Assistance Publique - Hôpitaux de Paris, Hôpital Cochin, Paris, France
  • 21 Unité de Prévention et de Contrôle de l'infection, Centre hospitalier, Saint Brieuc, France

The final, formatted version of the article will be published soon.

    Central venous catheters are critical in preterm neonatal care but increase the risk of central line-associated bloodstream infections (CLABSIs). Given the rising incidence of S. haemolyticus-associated CLABSIs in French neonates, we examined microorganisms in 108 central line infusion sets used in preterm infants across 12 neonatal intensive care units, and collected at the time of removal. The infusion sets varied widely in type (28 types; 1-6 parts) and length (10-180 cm, mean 52.9 cm). Contamination was detected in 24 infusion sets (22.2%), mainly by coagulase-negative Staphylococci (50.0%) and Bacillus species (41.7%). Higher contamination rates were linked to longer infusion lines (> 50 cm; p < 0.001), usage beyond 7 days (p = 0.002), and multi-line infusion systems (p < 0.001). Our findings are fully consistent with guidelines regarding infusion sets, which recommend simpler designs and a 4 or 7-day use of infusion sets, emphasizing the importance of adhering to the guidelines regarding infusion sets to reduce the risk of CLABSIs. Additionally, our findings raise concerns regarding the use of multi-line infusion systems. These devices, which combine extended infusion line length, manufacturer-authorized use of up to 21 days, and intermittent use of certain infusion lines, are easily contaminated during use, creating a high-risk situation for central line contamination.

    Keywords: Neonatalogy, infusion line, central line associated bacteremia, Central venous catheter, Umbilical catheter, peripherally inserted central catheter, Staphylococcus haemolyticus

    Received: 12 Sep 2024; Accepted: 23 Dec 2024.

    Copyright: © 2024 Dos Santos Borges, VALENTIN, Farizon, Charbonneau, Boukhris, Brat, Cazzorla, Chauvel, Cneude, Coutable, Demasure, Duminil, Faraut-Derouin, Gits-Muselli, Gorin, Goujon, Guillouche-Puissant, Hacinlioglu, Landelle, Lefebvre, Leroy-Terquem, Martinet, Massebeuf, Mazille-Orfanos, Ménard, Menvielle, Monin, Morange, Patkai, Perrault, Prat and van der Mee-Marquet. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Nathalie Laure van der Mee-Marquet, Hôpital Bretonneau, Centre d'Appui pour la Prévention des Infections Associées aux Soins (CPIAS) Centre - val de Loire, Centre Hospitalier Universitaire de Tours, Tours, 37044, France

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