Diagnostik und Therapie Katheter-assoziierter Infektionen in der pädiatrischen Onkologie

Impact of a modified Broviac maintenance care bundle on bloodstream infections in paediatric cancer patients

“…The comparative investigation of simultaneously sampled central and peripheral blood cultures in terms of differential time to positivity [ 43 ] adds to the early identification of the CVAD as the probable source of bacteraemia [ 44 ]. Without simultaneous peripheral venous cultures 14%–17% of all positive blood cultures remain undetected [ 45 ], [ 46 ].…”

“…However this is consistent with clinical practice reports where peripheral venous blood cultures were sampled in only 58% of all cases [ 47 ]. Furthermore, the practical impact of this procedure on the choice and duration of antibiotic treatment is negligible in most cases [ 44 ], [ 48 ]. Hence supportive care recommendations published on behalf of the German Society for Paediatric Oncology and Haematology (GPOH) and the German Society for Paediatric Infectious Diseases (DGPI) do not recommend the additional collection of peripheral venous blood cultures from febrile paediatric cancer patients with a long term central venous catheter (CVAD) [ 18 ], [ 44 ], [ 49 ].…”

Surveillance of bloodstream infections in pediatric cancer centers – what have we learned and how do we move on?

“…In spite of these observations, the sampling of peripheral venous blood cultures is not recommended in the current guidelines of the German Society of Pediatric Oncology and Hematology [ 18 ], [ 90 ], due to inconvenience and anxiety on the patients’ part related to an additional peripheral venous puncture. As a consequence of the missing second independently drawn blood culture, in accordance with standard CDC definitions [ 87 ], Kelly et al [ 10 ] did not include a significant proportion of all detected BSI in pediatric cancer patients in their analysis.…”