Background Catheter-related bloodstream infections (CR-BSI) cause high neonatal mortality and are related to inadequate aseptic technique during the care and maintenance of a catheter. The incidence of CR-BSI among neonates in Hung Vuong Hospital was higher than that of other neonatal care centres in Vietnam. Methods An 18-month pre- and post-intervention study was conducted over three 6-month periods to evaluate the effectiveness of the intervention for CR-BSI and to identify risk factors associated with CR-BSI. During the intervention period, we trained all nurses in the Department of Neonatology on BSI preventive practices, provided auditing and feedback about aseptic technique during catheter care and maintenance, and reorganised preparation of total parenteral nutrition. All neonates with intravenous catheter insertion ≥48 h in the pre- and post-intervention period were enrolled. A standardised questionnaire was used to collect data. Blood samples were collected for cultures. We used Poisson regression to calculate rate ratio (RR) and 95% confidence interval (CI) for CR-BSI incidence rates and logistic regression to identify risk factors associated with CR-BSI. Results Of 2225 neonates enrolled, 1027 were enrolled in the pre-intervention period, of which 53 CR-BSI cases occurred in 8399 catheter-days, and 1198 were enrolled in the post-intervention period, of which 32 CR-BSI cases occurred in 8324 catheter-days. Incidence rates of CR-BSI significantly decreased after the intervention (RR = 0.61, 95% CI 0.39-0.94). Days of hospitalisation, episodes of non-catheter-related hospital-acquired infections, and the proportion of deaths significantly decreased after the intervention (p < 0.01). The CR-BSI was associated with days of intravenous catheter (odds ratio [OR] = 1.05, 95% CI 1.03-1.08), use of endotracheal intubation (OR = 2.27, 95% CI 1.27-4.06), and intravenous injection (OR = 8.50, 95% CI 1.14-63.4). Conclusions The interventions significantly decreased the incidence rate of CR-BSI. Regular refresher training and auditing and feedback about aseptic technique during care and maintenance of catheters are critical to reducing CR-BSI.

中文翻译：

---

干预前后，越南洪武医院新生儿科加强的感染控制干预措施可减少与导管相关的血液感染。

背景导管相关的血流感染（CR-BSI）导致高新生儿死亡率，并且与导管的维护和保养过程中无菌技术不足有关。洪武医院新生儿的CR-BSI发生率高于越南其他新生儿护理中心。方法进行了为期18个月的干预前后的研究，历时3个6个月，以评估CR-BSI干预的有效性并确定与CR-BSI相关的危险因素。在干预期间，我们对新生儿科的所有护士进行了BSI预防措施的培训，对导管护理和维护期间的无菌技术提供了审核和反馈，并重新组织了总肠胃外营养的准备工作。纳入所有在干预前后静脉导管插入≥48h的新生儿。使用标准化的调查表收集数据。收集血样用于培养。我们使用Poisson回归来计算CR-BSI发生率的比率（RR）和95％置信区间（CI），并使用Logistic回归来确定与CR-BSI相关的危险因素。结果共有2225例新生儿进入干预前期，共1027例，其中53例CR-BSI病例在8399个导管日内发生，1198例在干预期后入院，其中32例CR-BSI病例在干预前发生。 8324导管天。干预后，CR-BSI的发生率显着降低（RR = 0.61，95％CI 0.39-0.94）。住院天数，非导管相关医院获得性感染的发作，干预后的死亡比例显着降低（p <0.01）。CR-BSI与静脉导管的天数（比值比[OR] = 1.05，95％CI 1.03-1.08），气管插管的使用（OR = 2.27，95％CI 1.27-4.06）和静脉注射（OR = 8.50，95％CI 1.14-63.4）。结论干预措施显着降低了CR-BSI的发生率。定期的进修培训和审核以及在导管保养和维护过程中有关无菌技术的反馈对于降低CR-BSI至关重要。结论干预措施显着降低了CR-BSI的发生率。定期的进修培训和审核以及在导管保养和维护过程中有关无菌技术的反馈对于降低CR-BSI至关重要。结论干预措施显着降低了CR-BSI的发生率。定期的进修培训和审核以及在导管保养和维护过程中有关无菌技术的反馈对于降低CR-BSI至关重要。