Search

Background: According to the Centres for Disease Control and Prevention, central line-associated bloodstream infection (CLABSI) is a laboratory-confirmed bloodstream infection not related to an infection at another site that develops within 48 h of central line placement. Central line-associated bloodstream infection in the Neonatal Intensive Care Unit contributes to increased morbidity and hospital mortality. This study aimed to prove the relationship between peripherally inserted central catheter dwell time and the incidence of CLABSI among neonates at our tertiary center hospital in Bali, Indonesia. Methods: This study was conducted based on a prospective cohort study design. The subjects were neonates admitted in levels 2 and 3 of the neonatology wards of Sanglah Hospital, Bali, Indonesia, between November 2018 to December 2020. The cases were followed during the insertion of a central catheter. Statistical analysis was performed using the Chi-square test and logistic regression with a p-value of < 0.05. Results: Subjects were recruited consecutively and fulfilled the research criteria as many as 114 people. A total of 63 subjects were excluded, and none of the cases was lost for follow-up. The incidence rate of CLABSI was obtained at 19.2‰ among the 114 subjects. The patients with a catheter dwell time of ˃ 14 days, compared to those with a catheter dwell time of ≤ 14 days, had a 2.9-fold risk of experiencing CLABSI (95% confidence interval: 1.191-7.497, P=0.02). No other risk factors were found for CLABSI development. Conclusion: The results of this study demonstrated that the risk of CLABSI in subjects with a catheter dwell time of ˃ 14 days was 2.9. Therefore, the implementation of the CLABSI bundle is necessary to decrease CLABSI incidence in neonates. [ABSTRACT FROM AUTHOR]

Background Hyperbilirubinemia is one of the most common problems in newborns. Severe hyperbilirubinemia, known as kernicterus, can suppress O2 consumption and oxidative phosphorylation, as well as damage brain cells, resulting in neuronal dysfunction and encephalopathy. Phototherapy is a common therapy for neonatal hyperbilirubinemia, but may rarely lead to the adverse effect of hypocalcemia. Objective To investigate serum calcium levels in full term neonates with hyperbilirubinemia, before and after phototherapy. Methods This cohort study compared total serum calcium level before and after phototherapy in full term neonates with hyperbilirubinemia. Subjects were full term neonates aged 2-14 days with high total serum bilirubin levels, according to the Bhutani curve, and were treated with phototherapy at Sanglah Hospital, Denpasar, Bali, Indonesia. Paired T-test was used to compare serum calcium levels before and after phototherapy. Results There were 35 subjects in this study. Paired T-test revealed that subjects’ serum calcium significantly decreased after phototherapy [before: 9.47 mg/dL vs. after: 9.23 mg/ dL; mean difference 0.24; (95%CI 0.03 to 0.46; P=0.025)]. None of our subjects had hypocalcemia after phototherapy. Conclusion Full term neonates with hyperbilirubinemia have reduced serum calcium levels after phototherapy. [ABSTRACT FROM AUTHOR]