Central Venous Catheter-related Blood Stream Infections in Children Undergoing Hematopoietic Stem Cell Transplant for Primary Immunodeficiency and Other Nonmalignant Disorders

Cole, Theresa; Rogerson, Elizabeth; Collins, Jennifer; Galloway, A.; Clark, Julia

doi:10.1097/inf.0b013e31822940a8

Cited by 5 publications

(7 citation statements)

References 9 publications

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“…It might be suggested that CVC may be changed in 7-10 day intervals, with the need for further studies. Cole et al 25 reported the prevalence of CLABSI in children whose stem cells were transplanted. They had found 5.3/1.000 central-line days and Staphylococcus epidermidis was the most commonly identified organism.…”

Section: Discussionmentioning

confidence: 99%

Central Line-Associated Bloodstream Infections in Pediatric Intensive Care Unit

Kendirli¹,

Yaman²,

Ödek³

et al. 2017

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Introduction:The aim of this study was to determine the frequency of central line-associated bloodstream infections, risk factors, their relationship with catheter insertion location, and the effect of central line-associated bloodstream infections on mortality and pediatric intensive care unit (PICU) length of stay. Methods: This was a prospective, observational and cohort study, carried out between November 2009 and February 2011. During this period, all the patients who had central-line were monitored for central line-associated bloodstream infection. Results: In the study period, 275 patients were admitted to our PICU. The frequency of invasive device usage was 38.9% (107) for central venous catheter, 38.2% (105) for mechanical ventilation, 53.3% (147) for urinary catheter, and 11.3% (32) for artery line. Central lineassociated bloodstream infection was detected in 16 (14.8%) of the patients and 23 central line-associated bloodstream infection attacks were observed. There were 14 central line-associated bloodstream infection attacks in 1.000 central venous catheter usage days. There were 168 patients without central venous catheter and 4 (2.4%) of them had blood stream infection. Thirty-six patients died and the mortality rate was 13%. Five of these patients (13.8%) died due to central line-associated bloodstream infection, 27 (25%) of them had central venous catheter and 9 (6%) of them did not (p=0.001). Conclusion:In conclusion, central line-associated bloodstream infection is one of the serious healthcare-associated infections, and it is an important cause of morbidity and mortality in PICUs. Keywords: Nosocomial infection, central line-associated bloodstream infection, pediatric intensive careGiriş: Bu çalışmanın amacı, kateter ilişkili kan dolaşımı enfeksiyonlarının sıklığını, risk faktörlerini, kateter yerleştirme yerleri ile olan ilişkisini, ayrıca bu enfeksiyonların mortalite ve çocuk yoğun bakım ünitesi (ÇYBÜ) kalış süresine olan etkisini belirlemektir. AbstractÖz

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Section: Discussionmentioning

confidence: 99%

Central Line-Associated Bloodstream Infections in Pediatric Intensive Care Unit

Kendirli¹,

Yaman²,

Ödek³

et al. 2017

cayd

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“…S. aureus , enteric gram-negative bacilli and Candida are less frequent but potentially more severe pathogens. Coagulase-negative Staphylococcus species ( S. epidermidis in particular) were the most common (>50%) pathogens identified from 146 episodes of bacteremia in 64 children with primary immunodeficiencies undergoing HSCT in Great North Children’s Hospital, whereas Enterococcus species, gram-negative organisms, and Candida were isolated only in few cases each ( 30 ). Most (80%) episodes were successfully treated with appropriate systemic and antibiotic locks; CVC was removed in 12 patients, and the only death resulted from overwhelming C. albicans infections despite CVC removal ( 30 ).…”

Section: Possible Risk Factors For Severe Infection and Deathmentioning

confidence: 99%

“…Coagulase-negative Staphylococcus species ( S. epidermidis in particular) were the most common (>50%) pathogens identified from 146 episodes of bacteremia in 64 children with primary immunodeficiencies undergoing HSCT in Great North Children’s Hospital, whereas Enterococcus species, gram-negative organisms, and Candida were isolated only in few cases each ( 30 ). Most (80%) episodes were successfully treated with appropriate systemic and antibiotic locks; CVC was removed in 12 patients, and the only death resulted from overwhelming C. albicans infections despite CVC removal ( 30 ). Contrary to that study, severe and life-threatening CVC-related sepsis caused by S. epidermidis has been reported in a significant percentage of children with systemic vasculitis treated with infliximab and combined immunosuppressive and/or antiinflammatory therapies ( 31 ).…”

Section: Possible Risk Factors For Severe Infection and Deathmentioning

confidence: 99%

Infection-Related Death among Persons with Refractory Juvenile Idiopathic Arthritis

Abinun¹,

Lane²,

Wood³

et al. 2016

Emerg. Infect. Dis.

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“…Another study revealed that incidence was 4.1 per 1.000 central linedays in third world countries [4]. Children with haemopoietic stem cell transplantation, prevalence of CLABSI was 5.3 per 1000 central-line days and most commonly identified organism was Staphylococcus epidermidis [5].…”

Section: Introductionmentioning

confidence: 99%

Asymptomatic central line-associated bloodstream infections in children implanted with long term indwelling central venous catheters in a teaching hospital, Sri Lanka

Jayaweera

Sivakumar

2020

BMC Infect Dis

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Background Indwelling central venous catheters (CVC) are used to provide long term hemodialysis. The commonest and the severe complication of CVC is the central line-associated bloodstream infection (CLABSI). This study was done to assess the etiology and infectious complications of CVC in children on long term hemodialysis. Methods Children newly undergoing hemodialysis and having indwelling CVC were included. They were followed up to a period of 2-years to assess infectious complications. Catheter bundle care approach was employed to prevent infections and other complications. Automated culture from the central catheter and peripheral vein and 2D echocardiography were done in each hemodialysis. Serial procalcitonin (PCT) was measured. Differential time of positivity (DTP) was used to detect CLABSI. During homestay in weekly telephone conversations were done to assess features of infection, and whenever having, we have asked to admit to the tertiary care unit. Logistic regression was performed, and the significant outcome variable was considered following multivariable analysis as a risk factor. Results Blood cultures were positive in 1090 (74.5%) out of 1462 children. According to DTP, 410 (28%) were having CLABSI, while 520 (35.6%) were having bacteremia without CLABSI. Out of 410 CLABSI patients, 79 (19.2%) were asymptomatic. Coagulase-negative Staphylococcus spp. (CoNS) bacteremia was significantly associated with asymptomatic CLABSI. Right-sided infective endocarditis (RS-IE) was significantly associated with asymptomatic CLABSI and asymptomatic bacteremia without CLABSI. CoNS was associated significantly in RS-IE following asymptomatic CLABSI and asymptomatic bacteremia. PCT was in asymptomatic CLABSI was 1.8 ± 0.9 ng/mL while in symptomatic CLABSI was 11.3 ± 2.5 ng/ml (P = 0.02). CoNS bloodstream infection, tunneled CVC, peripherally inserted central catheter, femoral site, the number of line days > 90, receipt of vancomycin, meropenem, or linezolid in the 5 days before CLABSI diagnosis and recurrent bacteremia were risk factors for asymptomatic CLABSI. Conclusions Asymptomatic CLABSI could be a rare occurrence. CoNS was predominantly isolated in patients with asymptomatic CLABSI. RS- IE is a well-known complication in long term indwelling CVC. CoNS was significantly associated with RS-IE following asymptomatic CLABSI. Regular procalcitonin, microbiological, and imaging studies would be essential to detect infectious complications in both symptomatic and asymptomatic patients implanted with long term indwelling CVCs.

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Central Venous Catheter-related Blood Stream Infections in Children Undergoing Hematopoietic Stem Cell Transplant for Primary Immunodeficiency and Other Nonmalignant Disorders

Cited by 5 publications

References 9 publications

Central Line-Associated Bloodstream Infections in Pediatric Intensive Care Unit

Central Line-Associated Bloodstream Infections in Pediatric Intensive Care Unit

Infection-Related Death among Persons with Refractory Juvenile Idiopathic Arthritis

Asymptomatic central line-associated bloodstream infections in children implanted with long term indwelling central venous catheters in a teaching hospital, Sri Lanka

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