Table 1

Three definitions of central line-associated bloodstream infection

SourceDefinitionClinical signsLaboratory markers
NEO-KISS39 Laboratory-confirmed bloodstream infection (LCBI) with coagulase negative staphylococcus (CoNS) isolated as sole pathogen
AND two clinical signs AND one laboratory parameter
OR Pathogen isolated from blood or cerebrospinal fluid culture, not related to infection at another site AND two clinical signs
LCBI with non-CoNS pathogen isolated in blood culture or cerebrospinal fluid, and pathogen not related to infections at other site AND two clinical signs
Clinical sepsis without proof of pathogen
No pathogens isolated from blood or culture not taken
Physician prescribes antimicrobials for at least 5 days
No apparent infection at another site
Two clinical signs, without other recognised cause
Fever>38°C or temperature instability (frequent incubator adjustment) or hypothermia<36.5°C
Unexplained metabolic acidosis Base Excess > −10
Tachycardia >200 bpm and/or bradycardia <80 bpm
New or more frequent apnoeas
Recapillarisation time >2 s
New hyperglycaemia>140 mg/dL
Other signs of infection:
Colour (when recapillarisation time not use), apathy, CRP, interleukin, increased oxygen requirement (intubation) or unstable condition
C-Reactive Protein>2.0 mg/dL
I/T ratio>0/2 *
Leukocytes<5/nL (without erythroblasts)
*immature granulocytes/total granulocytes
NNAP40 The growth of a recognised pathogen in pure culture OR in the case of a mixed growth, or growth of skin commensal, the added requirement for 3 or more of 10 predefined clinical signsTachypnoea/clinically relevant increase in oxygen or ventilation support
Clinically relevant increase in apnoea, bradycardias
Hypoglycaemia or hyperglycaemia
Impaired peripheral perfusion, pallor, mottling, Capillary Refill Time >3 s, toe-core gap>2
Lethargy, irritability, poor handling
Temperature instability
Ileus, feed intolerance
Reduced urine output
Metabolic acidosis BE >−10
CDC41 An LCBI where central line or umbilical catheter was in place for >2 calendar days on the date of event, with the day of device placement being day 1, AND the line was also in place on the date of event or the day before
LCBI: Patient of any age has a recognised pathogen identified AND organism identified in blood is not related to an infection at another site OR
Patient<1 year of age has at least one clinical sign AND organism identified from blood is not related to an infection at another site AND the same common commensal is identified from two or more specimens
Apnoea, or bradycardia