Prevention of central venous catheter-related bloodstream infection in the neonatal intensive care unit

Infekcije povezane sa zdravstvenom skrbi (HAI) problem su za mnoge pacijente, a pogotovo za novorođenčad koja su primljena u jedinice intenzivne skrbi. MeĎu tipove HAI ubrajaju se i one povezane s primjenom intravaskularnih katetera. Čimbenici rizika za nastanak ovih infekcija su nezreo imunološki i gastrointestinalni sustav, dijagnostički i terapijski postupci, te oslabljena funkcija koţne barijere. CRBSI (catheter-related bloodstream infection) označava infekciju povezanu s kateterom, a koja se dokazuje laboratorijskim testiranjem. Prevencija infekcija ovog tipa temelji se na razumijevanju mehanizama nastanka infekcije, razvoja bakterijskog biofilma, mogućnostima širenja mikroorganizama uporabom centralnog venskog katetera te u metodama prevencije. Posebno najvaţniji čimbenik u sprječavanju prijenosa mikroorganizama je higijena ruku te primjena aseptičnih tehnika tijekom uvođenja katetera i prilikom manipulacije istim kako bi se smanjila mogućnost prijenosa mikroorganizama. „Pet trenutaka za higijenu ruku“ označava ključne trenutke u provođenju dezinfekcije ruku. Korištenje koţnih antiseptika jedan je od vaţnijih koraka u prevenciji nastajanja infekcije, međutim, podaci o sigurnosti antiseptika na koţi novorođenčeta su oskudni stoga je potrebno upotrebljavati ih s oprezom. U cilju prevencije infekcija uzrokovanih putem centralnih katetera razvijene su smjernice u obliku snopova skrbi, koje sustavnom primjenom doprinose smanjenju pojave infekcija.Healthcare-associated infections (HAI) are a problem for many patients, and especially for newborns admitted to intensive care units. Types of HAI include those associated with the use of intravascular catheters. Risk factors for these infections include an immature immune and gastrointestinal system, diagnostic and therapeutic procedures, and impaired skin barrier function. CR-BSI (catheter-related bloodstream infection) means catheter-related infection that is proven by laboratory testing. Prevention of infections of this type is based on understanding the mechanisms of infection, the development of bacterial biofilm, the possibility of spreading microorganisms using a central venous catheter and prevention methods. The most important factor in preventing the transmission of microorganisms is hand hygiene and the application of aseptic techniques during the insertion of catheters and during their manipulation in order to reduce the possibility of transmission of microorganisms. "Five moments for hand hygiene" means key moments in implementation of hand disinfection methods. The use of skin antiseptics is one of the most important step in preventing the occurrence of infection, however, data on the safety of antiseptics on the skin of the newborn are scarce so it is necessary to use them with caution. In order to prevent infections caused by central catheters, guidelines have been developed in the form of care bundles, which, through systematic application, contribute to reducing the occurrence of infections