Table 5.
Distribution and Rank Ordera of the 15 Most Commonly Reported Pediatric Central Line-Associated Bloodstream Infection (CLABSI) Pathogens, by Location Type,b 2015–2017
| Pathogen | NICUsb | Pediatric ICUsa | Pediatric Oncology Unitsa | Pediatric Wardsa,b | ||||
|---|---|---|---|---|---|---|---|---|
| No. (%) Pathogens | Rank | No. (%) Pathogens | Rank | No. (%) Pathogens | Rank | No. (%) Pathogens | Rank | |
| Staphylococcus aureus | 1,381 (25.2) | 1 | 420 (12.6) | 2 | 266 (7.7) | 5 | 313 (12.4) | 2 |
| Coagulase-negative staphylococci | 1,145 (20.9) | 2 | 345 (10.4) | 4 | 316 (9.1) | 4 | 289 (11.4) | 3 |
| Escherichia coli | 596 (10.9) | 3 | 151 (4.5) | 9 | 429 (12.4) | 2 | 205 (8.1) | 5 |
| Enterococcus faecalisc | 483 (8.8) | 4 | 492 (14.8) | 1 | 179 (5.2) | 7 | 264 (10.4) | 4 |
| Selected Klebsiella spp | 408 (7.5) | 5 | 368 (11.0) | 3 | 374 (10.8) | 3 | 375 (14.8) | 1 |
| Candida albicansc | 243 (4.4) | 6 | 130 (3.9) | 10 | 41 (1.2) | 14 | 94 (3.7) | 9 |
| Enterobacter spp | 229 (4.2) | 7 | 278 (8.3) | 5 | 218 (6.3) | 6 | 191 (7.5) | 6 |
| Pseudomonas aeruginosa | 156 (2.8) | 8 | 167 (5.0) | 7 | 173 (5.0) | 8 | 78 (3.1) | 10 |
| Serratia spp | 150 (2.7) | 9 | 166 (5.0) | 8 | 20 (0.6) | 20 | 66 (2.6) | 11 |
| Other Candida sppc,d,e | 141 (2.6) | 10 | 207 (6.2) | 6 | 138 (4.0) | 9 | 120 (4.7) | 7 |
| Streptococcus agalactiae (GBS) | 130 (2.4) | 11 | 8 (0.2) | 24 | 7 (0.2) | 35 | 6 (0.2) | 23 |
| Acinetobacter spp | 47 (0.9) | 12 | 43 (1.3) | 13 | 24 (0.7) | 18 | 29 (1.1) | 14 |
| Other Enterococcus sppc,d | 46 (0.8) | 13 | 38 (1.1) | 14 | 60 (1.7) | 11 | 36 (1.4) | 13 |
| Candida glabratac | 36 (0.7) | 14 | 32 (1.0) | 15 | 21 (0.6) | 19 | 23 (0.9) | 16 |
| Citrobacter spp | 27 (0.5) | 15 | 19 (0.6) | 18 | 25 (0.7) | 17 | 23 (0.9) | 16 |
| Other | 256 (4.7) | 468 (14.0) | 1,177 (33.9) | 418 (16.5) | ||||
| Total | 5,474 (100.0) | 3,332 (100.0) | 3,468 (100.0) | 2,530 (100.0) | ||||
Note. Selected Klebsiella spp, K. oxytoca and K. pneumoniae; NICUs, neonatal intensive care units; ICUs, intensive care units; GBS, group B streptococci.
The 15 pathogens most commonly reported from NICUs are shown, along with their distribution and rank within the other location types. Some rankings within the other location types are not shown: ICUs: #11 (Enterococcus faecium), #12 (Stenotrophomonas maltophilia); oncology units: #1 (Viridans group streptococci; n = 507 [14.6%]), #10 (Enterococcus faecium), #11 (Rothia mucilaginosa), #13 (Stenotrophomonas maltophilia), #15 (Streptococcus pneumoniae); wards: #8 (Viridans group streptococci), #12 (Enterococcus faecium), #15 (Stenotrophomonas maltophilia).
Location types are mutually exclusive. NICUs are classified by NHSN location codes as level II/III and level III NICUs. ‘Pediatric wards’ includes step-down units, mixed acuity units, and specialty care areas.
When analyzed on the genus level, Candida and Enterococcus resulted in the following rankings: Candida – NICUs (#5), ICUs (#3), oncology units (#8), wards (#5); Enterococcus – NICUs (#4), ICUs (#1), oncology units (#4), wards (#2).
The group ‘Other Enterococcus spp’ combines enterococci identified to the species level, excluding E. faecium and E. faecalis, and enterococci for which the species was not reported. The group ‘Other Candida spp’ combines Candida identified to the species level, excluding C. albicans and C. glabrata, and Candida for which the species was not reported.
Candida parapsilosis was reported with the following frequencies: NICUs (104), ICUs (110), oncology units (55), wards (67).