Catheter‐related bloodstream infections in hematology

Worth, Leon J; Slavin, Monica A; Brown, Graham V.; Black, Jim

doi:10.1002/cncr.22527

Cited by 35 publications

(19 citation statements)

References 117 publications

(111 reference statements)

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“…CR-BSI is associated with prolonged hospitalization, increased healthcare costs, and increased mortality [20]. However, robust and reproducible surveillance strategies are not frequently employed in this population [21,22].…”

Section: Introductionmentioning

confidence: 99%

Infective and thrombotic complications of central venous catheters in patients with hematological malignancy: prospective evaluation of nontunneled devices

Worth

Seymour

Slavin

2008

Support Care Cancer

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Goals Central venous catheter (CVC)-related bloodstream infection (CR-BSI) is a significant complication in hematology patients. A range of CVC devices may be used, and risks for the development of complications are not uniform. The objectives of this study were to determine the natural history and rate of CVC-related complications and risk factors for CR-BSI and to compare device-specific complications in a hematology population. Patients and methods An observational cohort of patients with hematologic malignancy was prospectively studied following CVC insertion. Participants were reviewed until a CVC-related complication necessitated device removal, completion of therapy, death, or defined end-of-study date. The National Nosocomial Infection Surveillance definition for CR-BSI was used. Overall and device-specific rates of infective and noninfective complications were calculated and potential risk factors were captured.Main results One hundred six CVCs (75 peripherally inserted central venous catheters [PICCs], 31 nontunneled CVCs) were evaluated in 66 patients, over 2,399 CVC days. Thrombosis occurred in 16 cases (15.1%), exit-site infection in two (1.9%), and CR-BSI in 18 (7.5 per 1,000 CVC days). No significant differences were found when complication rates in PICC and nontunneled devices were compared. An underlying diagnosis of acute myeloid leukemia was negatively associated with CR-BSI (odds ratio (OR) 0.14, p=0.046), and a previous diagnosis of fungal infection was associated with infection (OR 22.82, p=0.031).Conclusions CR-BSI rates in our hematology population are comparable to prior reports. A low rate of exit-site infection and high proportion of thrombotic complications were observed. No significant differences in thrombotic or infective complications were evident when PICC and nontunneled devices were compared. PICC devices are a practical and safe option for management of hematology patients.

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Section: Introductionmentioning

confidence: 99%

Infective and thrombotic complications of central venous catheters in patients with hematological malignancy: prospective evaluation of nontunneled devices

Worth

Seymour

Slavin

2008

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“…Furthermore, the definition of CLABSI has not been standardized or well reported in individual studies. [17][18][19] In addition, the measurement of overall CLABSI risk per catheter days may not be directly applicable for the management of patients who present with fever and CVC. Immediate risk of bloodstream infection and complications may be a more applicable metric for clinical decision making.…”

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confidence: 97%

Outcome of Pediatric Gastroenterology Outpatients With Fever and Central Line

Alexander

Blatt²,

Skinner³

et al. 2016

Pediatr Emer Care

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“…1 Some bloodstream infections (BSIs) meet the NHSN CLABSI definition but are not related to central-line care. [2][3][4][5][6][7][8] For example, among immunocompromised patients, BSIs may result from translocation of gut microorganisms related to mucosal barrier injury, defined as alteration of normal gastrointestinal microbiota, or loss of mucosal integrity in the setting of impaired host defenses. 9,10 To identify the subset of CLABSIs most likely associated with mucosal barrier injury among oncology patients and therefore less likely to be prevented through evidence-based central line insertion and maintenance practices, the mucosal barrier injury-laboratory confirmed bloodstream infection (MBI-LCBI) definition was established in NHSN.…”

mentioning

confidence: 99%

Mucosal Barrier Injury Laboratory-Confirmed Bloodstream Infections (MBI-LCBI): Descriptive Analysis of Data Reported to National Healthcare Safety Network (NHSN), 2013

Epstein

See

Edwards

et al. 2015

Infect. Control Hosp. Epidemiol.

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OBJECTIVES To determine the impact of mucosal barrier injury laboratory-confirmed bloodstream infections (MBI-LCBIs) on central-line-associated bloodstream infection (CLABSI) rates during the first year of MBI-LCBI reporting to the National Healthcare Safety Network (NHSN) DESIGN Descriptive analysis of 2013 NHSN data SETTING Selected inpatient locations in acute care hospitals METHODS A descriptive analysis of MBI-LCBI cases was performed. CLABSI rates per 1,000 central-line days were calculated with and without the inclusion of MBI-LCBIs in the subset of locations reporting ≥1 MBI-LCBI, and in all locations (regardless of MBI-LCBI reporting) to determine rate differences overall and by location type. RESULTS From 418 locations in 252 acute care hospitals reporting ≥1 MBI-LCBIs, 3,162 CLABSIs were reported; 1,415 (44.7%) met the MBI-LCBI definition. Among these locations, removing MBI-LCBI from the CLABSI rate determination produced the greatest CLABSI rate decreases in oncology (49%) and ward locations (45%). Among all locations reporting CLABSI data, including those reporting no MBI-LCBIs, removing MBI-LCBI reduced rates by 8%. Here, the greatest decrease was in oncology locations (38% decrease); decreases in other locations ranged from 1.2% to 4.2%. CONCLUSIONS An understanding of the potential impact of removing MBI-LCBIs from CLABSI data is needed to accurately interpret CLABSI trends over time and to inform changes to state and federal reporting programs. Whereas the MBI-LCBI definition may have a large impact on CLABSI rates in locations where patients with certain clinical conditions are cared for, the impact of MBI-LCBIs on overall CLABSI rates across inpatient locations appears to be more modest. Infect. Control Hosp. Epidemiol. 2015;37(1):2-7.

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Catheter‐related bloodstream infections in hematology

Cited by 35 publications

References 117 publications

Infective and thrombotic complications of central venous catheters in patients with hematological malignancy: prospective evaluation of nontunneled devices

Infective and thrombotic complications of central venous catheters in patients with hematological malignancy: prospective evaluation of nontunneled devices

Outcome of Pediatric Gastroenterology Outpatients With Fever and Central Line

Mucosal Barrier Injury Laboratory-Confirmed Bloodstream Infections (MBI-LCBI): Descriptive Analysis of Data Reported to National Healthcare Safety Network (NHSN), 2013

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