الفهرس 
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Abstract
Neonates (newborns) are usually exposed to various conditions that may affect their clinical status and lead them to be admitted in the intensive care unit. Due to their small age (≤28 days) and immaturity they need several invasive interventions for their life support.
One of the important needs in the neonatal intensive care is the central venous catheter to allow the entrance of essential fluids and drugs in their tiny bodies. Although it is very useful for their treatment, it can be a potential source of infection. In NICUs, CLABSI is the most predominant nosocomial infection. Many studies suggested that compliance to insertion and care bundles help in prevention of CLABSI. One of the important points in the bundles was the type of dressing used to secure the central catheter.
The aim of the study was to compare between the effectiveness of “transparent film dressing”, “gauze & tape”, and “postoperative dressing” in decreasing central line associated bloodstream infections in neonates.
The study was performed in the NICU of a governmental pediatric hospital where the type of dressing and its effect on the incidence of CLABSI was observed for 12 months from march 2021 till march 2022.
Collection of data was performed from the neonates’ files. The enrolled neonates were divided into three equal groups according to the dressing type used for the care of the central catheter. group one was using transparent polyurethane dressing, group two used gauze & tape and group three used postoperative dressing.
The study showed that there was no relation between the incidence of CLABSI and the gender, weight to gestational age, anomaly and residence area. Only the maturity showed statistical relation (p= 0.012). The percentage of CLABSI was higher in full term (29%) than preterm (22.8%). Also, the study detected that the high rate of ulceration was accompanied with the use of Gauze &Tape (86%) followed by postoperative dressing (24%) and transparent dressing (8%). There was statistical significance between confirmed CLABSI with blood culture and both ulceration (p= 0.047) and the type of dressing (p= 0.0002). Klebsiella species was the most dominant organism (15.3%) followed by Coagulase negative staphylococcus (9.3%). The current study detected a statistical significance between diagnosis with blood culture for CLABSI and the diagnosis with CRP, NLR & NOSEP (p= 0.000) (p= 0.012), (p= 0.000) respectively. CRP was the highest in specificity (83.6%) followed by NOSEP (79.1%) and NLR (30%). Regarding sensitivity, NLR was more sensitive (90%) than CRP and NOSEP (both were 87.5%).
The postoperative dressing was the highest dressing associated with CLABSI (44%) followed by Gauze & Tape and transparent dressing (28%, 8%) respectively. As well, CRP, NLR and NOSEP showed strong statistical significance with the type of dressing (p = 0.002), (p = 0.001), (p = 0.001) respectively. It revealed also that the postoperative dressing was the highest dressing associated with predicted infection (45.3%, 38.1%, 44.8%) followed by Gauze & Tape (39.6%, 37.2%, 39.7%) and transparent dressing (15.1%, 24.8%, 15.5%) respectively.