Early central line‐associated blood stream infections in children with cancer pose a risk for premature catheter removal

Moell, Jacob; Svenningsson, Anna; Sandeberg, Margareta af; Larsson, Magnus; Heyman, Mats; Harila‐Saari, Arja; Nilsson, Anna

doi:10.1111/apa.14432

Cited by 6 publications

(9 citation statements)

References 26 publications

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“…In their study, Moell et al noted that the overall incidence of central line‐associated BSIs in their hospital was 2.0 per 1000 catheter days, which was similar to other published studies . They also reported that an early central line‐associated BSI one month after the insertion of a CVC was a risk of a premature catheter removal.…”

supporting

confidence: 75%

“…The lowest risk of blood‐borne infections occurs in totally implantable venous access ports, but children who need parenteral nutrition may have a higher risk of an infection with these ports than with an external CVC . However, they were the most common form of venous access used in Moell et al's study .…”

mentioning

confidence: 99%

“…Perioperative complications, such as pneumothorax or haemorrhage, have been related to difficulties with insertions and infections, thrombosis and dysfunctions of CVCs are common long‐term problems. In this issue of Acta Paediatrica , a Swedish study by Moell et al reports that having an early blood stream infection (BSI) was a risk of premature catheter removal in children with cancer.…”

mentioning

confidence: 99%

“…Moell et al found that the most common pathogen isolated in blood cultures was coagulase‐negative staphylococcus, which colonises normal skin and can sometimes contaminate blood cultures. Daily handling of CVCs increases the risk of infections from skin bacteria, and staphylococci are the most common pathogen in real catheter‐related infections, namely central line‐related BSIs .…”

mentioning

confidence: 99%

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Central venous catheter care for children with cancer should focus on early infections

Anttila

2018

Acta Paediatrica

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supporting

confidence: 75%

mentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Central venous catheter care for children with cancer should focus on early infections

Anttila

2018

Acta Paediatrica

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“…Two types of central access device are most commonly used in pediatric cancer care: central venous catheters (CVC) and subcutaneous venous ports (SVP; Mangum et al, ). Several complications, such as infections, can be associated with the insertion of a central access device (Moell et al, ). Patients with an SVP have fewer complications than patients with a CVC (Coady, Ali, Sidloff, Kenningham, & Ahmed, ; Fang, Yang, Song, Jiang, & Liu, ) and also report a higher quality of life than those with a CVC (Fang et al, ).…”

Section: Introductionmentioning

confidence: 99%

Focusing on the hospital stay or everyday life with cancer: Parents’ experiences of choosing a central access device for their child with cancer

Bergviken

Nilsson

2019

Specialist Pediatric Nursing

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Purpose: The aim of this study was to gain insights into the experiences of parents of children with cancer in conjunction with their decisions on the type of central access device that their child would have. Design and Methods: The qualitative study design was chosen to maximize the likelihood of capturing the full range of the phenomenon, that is the parents' experiences from decision-making. Open interviews were conducted between December 2015 and January 2016 with 17 parents of children who had been diagnosed with cancer in 2014-2015. The interviews were analyzed using inductive qualitative content analysis. Results: The analysis of the decision-making process data yielded four subcategories: (a) Feeling overwhelmed owing to limited information and alienation within the healthcare system, (b) the burden of making a quick medical decision without having the big picture, (c) receiving conflicting views and approaches from the healthcare professionals, and (d) including the child's perspective. Those four subcategories were condensed into the following main category: focusing on the hospital stay and treatment or on everyday life with cancer.

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Bloodstream infections in adult patients with malignancy, epidemiology, microbiology, and risk factors associated with mortality and multi-drug resistance

et al. 2021

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Background This study aimed to investigate the epidemiology, microbiology, and risk factors associated with mortality and multi-drug resistance bacterial bloodstream infections (BSIs) among adult cancer patients in Shiraz, Iran. We also report a four-year trend of antimicrobial resistance patterns of BSIs. Methods We conducted a retrospective study at a referral oncology hospital from July 2015 to August 2019, which included all adults with confirmed BSI. Results 2393 blood cultures tested during the four-year study period; 414 positive cultures were included. The mean age of our patients was 47.57 ± 17.46 years old. Central Line-Associated BSI (CLABSI) was more common in solid tumors than patients with hematological malignancies. Gram-negative (GN) bacteria were more detected (63.3%, 262) than gram-positive bacteria (36.7%, 152). Escherichia coli was the most common gram-negative organism (123/262, 47%), followed by Pseudomonas spp. (82/262, 31%) and Klebsiella pneumoniae (38/262, 14.5%). Coagulase-negative staphylococci (CoNS) was the most frequently isolated pathogen among gram-positive bacteria (83/152, 54.6%). Acinetobacter spp., Pseudomonas spp., E. coli, and K. pneumoniae were the most common Extended-Spectrum Beta-Lactamase (ESBL) producers (100, 96.2, 66.7%, and 60.7, respectively). Acinetobacter spp., Pseudomonas spp., Enterobacter spp., E. coli, and K. pneumoniae were the most common carbapenem-resistant (CR) isolates (77.8, 70.7, 33.3, 24.4, and 13.2%, respectively). Out of 257 Enterobacterales and non-fermenter gram-negative BSIs, 39.3% (101/257) were carbapenem-resistant. Although the incidence of multi-drug resistance (MDR) gram-negative BSI increased annually during 2015–2018, the mortality rate of gram-negative BSI remains unchanged at about 20% (p-value = 0.55); however, the mortality rate was significantly greater (35.4%) in those with resistant gram-positive BSI (p-value = 0.001). The overall mortality rate was 21.5%. Early (7-day mortality) and late mortality rate (30-day mortality) were 10 and 3.4%, respectively. Conclusions The emergence of MDR gram-negative BSI is a significant healthcare problem in oncology centers. The high proportion of the most frequently isolated pathogens were CR and ESBL-producing Enterobacterales and Pseudomonas spp. We have few effective choices against MDRGN BSI, especially in high-risk cancer patients, which necessitate newer treatment options.

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Early central line‐associated blood stream infections in children with cancer pose a risk for premature catheter removal

Abstract: We observed a high prevalence of early CVC associated blood stream infection mainly in patients with haematological malignancies. Our study highlights the importance of preventive measures in reducing infections in paediatric cancer patients.

Cited by 6 publications

References 26 publications

Central venous catheter care for children with cancer should focus on early infections

Central venous catheter care for children with cancer should focus on early infections

Focusing on the hospital stay or everyday life with cancer: Parents’ experiences of choosing a central access device for their child with cancer

Bloodstream infections in adult patients with malignancy, epidemiology, microbiology, and risk factors associated with mortality and multi-drug resistance

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