Catheter management across patients with hematologic malignancies and catheter-related blood stream infections: a systematic review

Heybati, Kiyan; Seeger, Rena; Thyagu, Santhosh; Piticaru, Joshua; Ahluwalia, Nanki; Munshi, Laveena

doi:10.1007/s00277-022-04969-7

Cited by 4 publications

(6 citation statements)

References 29 publications

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“…We found that 25 % of the VSEfm bacteraemia patients did not receive any comprehensive enterococcal antibiotic treatment. Furthermore, we found a significant impact of catheter removal or change on reducing the 30 day mortality in patients not treated with antibiotics active against enterococci, which corresponds to results in other studies [40]. This may indicate the ability of E.…”

Section: Discussionsupporting

confidence: 89%

Vancomycin-sensitive Enterococcus faecium bacteraemia – hospital transmission and mortality in a Danish University Hospital

Hansen

Roer

Karstensen

et al. 2023

Journal of Medical Microbiology

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Introduction. The emergence of vancomycin-resistant Enterococcus faecium (VREfm) has left the vancomycin-sensitive E. faecium (VSEfm) strains almost unnoticed. Hypothesis. Molecular characteristics, hospital transmission patterns and clinical impact of VSEfm have changed, and VSEfm is a predictor of VREfm introduction. Aim. We wanted to do a molecular characterization of VSEfm to identify hospital transmissions and links between VSEfm and VREfm, and to investigate the demographics, treatment and impact on mortality of VSEfm bacteraemia. Methodology. VSEfm and VREfm blood culture isolates from Odense University Hospital, Denmark, from 2015 to 2019 were characterized using whole-genome sequencing and core-genome multilocus sequence typing (cgMLST). Clonal shifts and diversity of the VREfm isolates were compared to the VSEfm isolates. Hospital records were used for clinical data and transmission investigation of VSEfm cases. Results. Six-hundred and thirty VSEfm isolates from 599 patients belonged to 42 sequence types (STs) and 131 complex types (CTs) in several clusters. Multiple types were involved in putative transmission, occurring over the entire period. Twenty-seven VREfm bacteraemia cases were included. No correlation between the VSEfm and VREfm clones was identified. The 30 day mortality was 40 %, but only in 6.3 % of the cases, VSEfm bacteraemia was the likely cause of death. Conclusion. The molecular types of VSEfm bacteraemia isolates are changing and diverse. No direct correlation between VSEfm and the introduction of VREfm was found, but widespread hospital transmission indicates a presence of risk factors that could facilitate transmission of other micro-organisms as well. VSEfm bacteraemia is rarely the cause of death, indicating that 30 day mortality does not reflect the cause of death.

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Section: Discussionsupporting

confidence: 89%

Vancomycin-sensitive Enterococcus faecium bacteraemia – hospital transmission and mortality in a Danish University Hospital

Hansen

Roer

Karstensen

et al. 2023

Journal of Medical Microbiology

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“…Furthermore, our hospital provides aggressive treatment for children with acute lymphoblastic leukemia and acute myeloid leukemia, which may have contributed to the persistent CoNS bacteremia group being significantly younger than the persistent S. aureus bacteremia group. The frequent administration of drugs in patients with hematologic malignancies often necessitates the implantation of intravascular devices to facilitate long-term systemic treatment [ 19 ]. In the present study, all 15 patients (100%) with persistent CoNS bacteremia and hematologic malignancies had implanted devices.…”

Section: Discussionmentioning

confidence: 99%

Clinical Characteristics and Outcomes of Persistent Staphylococcal Bacteremia in a Tertiary Care Hospital

et al. 2023

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Clinical outcomes of persistent staphylococcal bacteremia vary depending on the causative organism. This secondary data analysis study compared the clinical characteristics of persistent Staphylococcus aureus (S. aureus)- and coagulase-negative staphylococci (CoNS)-caused bacteremia, focusing on the methicillin-resistant status. This study used data collected from patients who underwent blood cultures between January 2012 and December 2021 at Tohoku University Hospital, Japan. Patients with persistent staphylococcal bacteremia were divided into groups based on the pathogen and methicillin-resistant status, and their characteristics were analyzed. The primary outcomes were early (30-day), late (30–90 days), and 90-day mortality rates. The early, late, and 90-day mortality rates were similar between the persistent CoNS and S. aureus bacteremia groups. Patients with persistent methicillin-resistant S. aureus (MRSA) bacteremia tended to have higher early, late, and 90-day mortality rates than those with persistent methicillin-susceptible S. aureus bacteremia (not statistically significant). No differences were observed between the methicillin-resistant and-susceptible CoNS groups. In patients with persistent CoNS bacteremia, mortality tended to increase, especially in debilitated or immunocompromised patients with distant metastases, underscoring the importance of infection source control. Mortality tended to be high in patients with persistent MRSA bacteremia, especially when persistent bacteremia clearance was not confirmed, illustrating the need for careful therapeutic management.

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“…Long hospital stays, underlying diseases such as neurological disorders, and solid organ transplantation associated with a higher risk of CRBSI. 23,40 Chemical or mechanical reaction at the site of the catheter insertion is an important cause of thrombophlebitis. 3,6,41,42 The lumens of central veins are larger than those of peripheral veins; therefore, chemical and mechanical reactions to the catheter have less effect on central veins than that on peripheral veins.…”

Section: Discussionmentioning

confidence: 99%

“…13 Therefore, in some cases, the clinical diagnosis of CRBSI may be difficult. 4,5,15,23 Imaging evaluation is used to evaluate patients with fever, and recently, some case reports have reported that imaging findings can be useful for diagnosing CRBSI. [24][25][26][27] Furthermore, to decide whether to recommend surgical intervention for CRBSI, the extent of the infection needs to be determined using imaging evaluation.…”

mentioning

confidence: 99%

“…In addition, blood cultures contain contaminants, depending on the medical team's skill of obtaining blood culture 13 . Therefore, in some cases, the clinical diagnosis of CRBSI may be difficult 4,5,15,23 . Imaging evaluation is used to evaluate patients with fever, and recently, some case reports have reported that imaging findings can be useful for diagnosing CRBSI 24–27 .…”

mentioning

confidence: 99%

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Ultrasonographic Findings of Catheter‐Related Bloodstream Infection in Pediatric Patients

Hosokawa,

Deguchi,

Takei

et al. 2023

J of Ultrasound Medicine

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BackgroundCatheter removal is essential for treating catheter‐related bloodstream infection (CRBSI); however, clinicians are sometimes hesitant to remove catheters in pediatric patients due to the difficulty of securing vascular access. Confirming the diagnosis of CRBSI is important to justify catheter removal. The purpose of this study was to describe the sonographic findings of CRBSI.Materials and MethodsWe included patients with a central venous catheter (CVC) or peripherally inserted central catheter (PICC) who had a positive blood culture and underwent ultrasound. The patients were classified as with or without CRBSI. Sonographic findings, such as the presence/absence of thrombus, venous wall thickening, hyperechogenicity, and fluid collection around the vein were compared using Fisher's exact test.ResultsOf the 58 patients, 38 (66%) were diagnosed with CRBSI. The presence of thrombus (19/38 vs 3/20, P = .011); and hyperechogenicity around the vein (14/38 vs 2/20, P = .035) differed significantly, but There was no significant difference in the presence of venous wall thickening (10/38 vs 1/20, P = .077), and fluid collection around the vein (5/38 vs 0/20, P = .153), did not differ significantly in patients with and without CRBSI, respectively. One‐third of patients with CRBSI, including 11 (42.3%) patients with CVC, and 2 (16.7%) patients with PICC, did not have abnormal sonographic findings.ConclusionUltrasound findings are useful for diagnosing CRBSI. However, the sensitivity of sonographic findings is low and abnormal sonographic findings are sometimes absent in children with CRBSI; therefore, physicians should not rule out CRBSI based on normal sonographic findings, especially in patients a CVC and a positive blood culture.

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Catheter management across patients with hematologic malignancies and catheter-related blood stream infections: a systematic review

Cited by 4 publications

References 29 publications

Vancomycin-sensitive Enterococcus faecium bacteraemia – hospital transmission and mortality in a Danish University Hospital

Vancomycin-sensitive Enterococcus faecium bacteraemia – hospital transmission and mortality in a Danish University Hospital

Clinical Characteristics and Outcomes of Persistent Staphylococcal Bacteremia in a Tertiary Care Hospital

Ultrasonographic Findings of Catheter‐Related Bloodstream Infection in Pediatric Patients

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