Identification and characterization of catheter-related bloodstream infections due to viridans group streptococci in patients with cancer

Shelburne, Samuel A.; Chaftari, Anne-Marie; Mohamed, Jamal A.; Wohoush, Iba Al; Jiang, Ying; Abughazaleh, Shaadi; Cairo, Javier; Raad, Sammy; Debiane, Labib; Raad, Issam

doi:10.1016/j.ajic.2014.06.012

Cited by 15 publications

(19 citation statements)

References 10 publications

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“…The regimen and antimicrobial spectrum required depend on the range of pathogens that typically cause infections in the population of interest. Prophylaxis with a broad-spectrum fluoroquinolone such as levofloxacin is effective, but breakthrough infections with Gram-positive bacteria have been reported, and additional broad-spectrum Gram-positive coverage would appear ideal (1,(3)(4)(5)(6)(7)(8). This is the first study to examine the effects of prophylactic regimens containing vancomycin on the risk of AKI, hepatotoxicity, or CDI in children and adolescents with neutropenia.…”

Section: Discussionmentioning

confidence: 99%

Adverse Effects of Intravenous Vancomycin-Based Prophylaxis during Therapy for Pediatric Acute Myeloid Leukemia

Sun

Huskey

et al. 2018

Antimicrob Agents Chemother

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Children and adolescents with acute myeloid leukemia (AML) are at risk of life-threatening bacterial infections, especially with viridans group streptococci. Primary antibacterial prophylaxis with vancomycin-based regimens reduces this risk but might increase the risks of renal or liver toxicity or infection (CDI). A retrospective review of data for patients treated for newly diagnosed AML at St. Jude Children's Research Hospital between 2002 and 2008 was conducted. Nephrotoxicity was classified according to pediatric risk, injury, failure, loss, and end-stage renal disease (pRIFLE) criteria and hepatotoxicity according to Common Terminology Criteria for Adverse Events (CTCAE) criteria. The risks of nephrotoxicity, hepatotoxicity, and CDI were compared between patients receiving vancomycin-based prophylaxis, no intravenous prophylaxis, or other prophylaxis. Generalized linear mixed models were used to address potential confounding. A total of 392 chemotherapy courses (108 with no intravenous prophylaxis, 218 with vancomycin-based prophylaxis, and 66 with other prophylaxis) for 111 patients were included. Development of pRIFLE risk, injury, and failure occurred in 190, 44, and 2 courses, respectively. Increases of at least one, two, and three grades for hepatotoxicity occurred in 189, 52, and 19 courses, respectively. After adjustment for confounders, vancomycin-based prophylaxis was not associated with nephrotoxicity or hepatotoxicity and reduced the risk of CDI, compared to no intravenous prophylaxis (0.9% versus 6.5%; = 0.007) or other prophylactic regimens (0.9% versus 3.0%; = 0.23). Despite concerns about vancomycin toxicity, vancomycin-based prophylaxis in pediatric patients with AML did not increase the risk of nephrotoxicity or hepatotoxicity and reduced the risk of CDI. Caution is advised to avoid contributing to antibiotic resistance.

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Section: Discussionmentioning

confidence: 99%

Adverse Effects of Intravenous Vancomycin-Based Prophylaxis during Therapy for Pediatric Acute Myeloid Leukemia

Sun

Huskey

et al. 2018

Antimicrob Agents Chemother

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“…This decrease may remove CLABSIs from the spotlight, but it makes them no less clinically meaningful or important to prevent. Shelburne et al 20 underscored that caution is needed when using the MBI-LCBI definition. In their study, many patients with definite centralline infections according to strict, clinical, Infectious Disease Society of America criteria were classified as MBI-LCBIs.…”

Section: Discussionmentioning

confidence: 99%

“…In their study, many patients with definite centralline infections according to strict, clinical, Infectious Disease Society of America criteria were classified as MBI-LCBIs. 20 It will be important to continue to track, critically appraise and address MBI-LCBIs. This requires, as we propose, keeping MBI-LCBIs on the dashboard of BSIs reviewed by healthcare systems, payors, and the public.…”

Section: Discussionmentioning

confidence: 99%

A Prospective, Holistic, Multicenter Approach to Tracking and Understanding Bloodstream Infections in Pediatric Hematology-Oncology Patients

Gaur

Bundy

Werner

et al. 2017

Infect. Control Hosp. Epidemiol.

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objective. To assess the burden of bloodstream infections (BSIs) among pediatric hematology-oncology (PHO) inpatients, to propose a comprehensive, all-BSI tracking approach, and to discuss how such an approach helps better inform within-center and across-center differences in CLABSI rate.design. Prospective cohort study.setting. US multicenter, quality-improvement, BSI prevention network.participants. PHO centers across the United States who agreed to follow a standardized central-line-maintenance care bundle and track all BSI events and central-line days every month.methods. Infections were categorized as CLABSI (stratified by mucosal barrier injury-related, laboratory-confirmed BSI [MBI-LCBI] versus non-MBI-LCBI) and secondary BSI, using National Healthcare Safety Network (NHSN) definitions. Single positive blood cultures (SPBCs) with NHSN defined common commensals were also tracked.results. Between 2013 and 2015, 34 PHO centers reported 1,110 BSIs. Among them, 708 (63.8%) were CLABSIs, 170 (15.3%) were secondary BSIs, and 232 (20.9%) were SPBCs. Most SPBCs (75%) occurred in patients with profound neutropenia; 22% of SPBCs were viridans group streptococci. Among the CLABSIs, 51% were MBI-LCBI. Excluding SPBCs, CLABSI rates were higher (88% vs 77%) and secondary BSI rates were lower (12% vs 23%) after the NHSN updated the definition of secondary BSI (P < .001). Preliminary analyses showed across-center differences in CLABSI versus secondary BSI and between SPBC and CLABSI versus non-CLABSI rates.conclusions. Tracking all BSIs, not just CLABSIs in PHO patients, is a patient-centered, clinically relevant approach that could help better assess across-center and within-center differences in infection rates, including CLABSI. This approach enables informed decision making by healthcare providers, payors, and the public. 2017;38:690-696 Bloodstream infections (BSIs) cause morbidity and mortality and are especially concerning in pediatric hematology-oncology (PHO) patients. 1 Most oncology patients and some hematology patients have a long-term central line that facilitates their treatment, and these devices can be a source of centralline-associated BSI (CLABSI). Other sources of BSI in immunosuppressed PHO patients include disrupted skin or mucosal surfaces, such as the upper or lower gastrointestinal tract, and deep-seated infections. Frequently, an obvious source of BSI cannot be found. CLABSIs in inpatients are considered healthcare-associated infections that are preventable and must be reported 2 to payors and local, state, and federal agencies, with implications for reimbursement. 3,4 As a result, BSI surveillance in PHO inpatients has disproportionately focused on CLABSIs; the Centers for Disease Control and Prevention's National Healthcare Safety Network (NHSN) surveillance definition of CLABSI is widely used for this purpose. 5 A BSI from an alternate source of infection (other than the central line), defined by the NHSN as "secondary BSI," has not received similar scrutiny. Additionally, the NHSN definitio...

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“…The most common causes of diseases and infections such as bacteremia, meningitis, serious infections in neonates, hospital infections, endocarditis, nosocomial infections, formation of dental caries, urinary infections, infections of wounds and burns to septicemia, etc. are bacteria [3][4][5][6]. Their rapid identification from biological samples is one of the most important goals in human health care.…”

Section: Introductionmentioning

confidence: 99%

PCB sensor for bacteria detection in saline

Vasiljević

Stojanović

Radovanović

et al. 2017

2017 IEEE MTT-S International Microwave Workshop Series on Advanced Materials and Processes for RF and THz Applications (IMWS-A

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This paper represents design, fabrication and characterization of non-invasive capacitive sensor for detection of different concentrations of bacteria such as Pseudomonas aeruginosa and Staphylococcus aureus in saline. The sensor was fabricated in printed circuit board (PCB) technology and it consists of a pair of interdigitated electrodes. In house measurement setup for testing and characterization of sensors has been developed. The characteristics of sensor-the capacitance as a function of frequency for a different concentrations of each bacteria are presented. The obtained results demonstrate different resonant frequencies for each dilution of Pseudomonas aeruginosa and Staphylococcus aureus in physiological saline.

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Identification and characterization of catheter-related bloodstream infections due to viridans group streptococci in patients with cancer

Cited by 15 publications

References 10 publications

Adverse Effects of Intravenous Vancomycin-Based Prophylaxis during Therapy for Pediatric Acute Myeloid Leukemia

Adverse Effects of Intravenous Vancomycin-Based Prophylaxis during Therapy for Pediatric Acute Myeloid Leukemia

A Prospective, Holistic, Multicenter Approach to Tracking and Understanding Bloodstream Infections in Pediatric Hematology-Oncology Patients

PCB sensor for bacteria detection in saline

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