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Central-line–associated bloodstream infections and central-line–associated non-CLABSI complications among pediatric oncology patients

OBJECTIVE: To assess central venous catheter (CVC) harm in pediatric oncology patients, we explored risks for central-line–associated bloodstream infections (CLABSIs) and central-line–associated non-CLABSI complications (CLANCs). DESIGN: Retrospective cohort study. SETTING: Midwestern US pediatric o...

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Autores principales: Kelada, Aml S., Foster, Timothy B., Gagliano, Gregory C., Worley, Sarah, Tang, Anne, Arakoni, Venkatraman A., Foster, Charles B.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cambridge University Press 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10015264/
https://www.ncbi.nlm.nih.gov/pubmed/35475427
http://dx.doi.org/10.1017/ice.2022.91
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author Kelada, Aml S.
Foster, Timothy B.
Gagliano, Gregory C.
Worley, Sarah
Tang, Anne
Arakoni, Venkatraman A.
Foster, Charles B.
author_facet Kelada, Aml S.
Foster, Timothy B.
Gagliano, Gregory C.
Worley, Sarah
Tang, Anne
Arakoni, Venkatraman A.
Foster, Charles B.
author_sort Kelada, Aml S.
collection PubMed
description OBJECTIVE: To assess central venous catheter (CVC) harm in pediatric oncology patients, we explored risks for central-line–associated bloodstream infections (CLABSIs) and central-line–associated non-CLABSI complications (CLANCs). DESIGN: Retrospective cohort study. SETTING: Midwestern US pediatric oncology program. PATIENTS: The study cohort comprised 592 pediatric oncology patients seen between 2006 and 2016. METHODS: CLABSIs were defined according to Centers for Disease Control and Prevention (CDC)/National Health Safety Network (NHSN) definitions. CLANCs were classified using a novel definition requiring CVC removal. Patient-level and central-line–level risks were calculated using a negative binomial model to adjust for correlations between total events and line numbers. RESULTS: CVCs were inserted in 62% of patients, with 175,937 total catheter days. The inpatient CLABSI and CLANC rates were 5.8 and 8.5 times higher than outpatient rates. At the patient level, shared risks included acute myeloid leukemia (AML) and age <1 year at diagnosis. At the line level, shared risks included age <1 year at diagnosis, non-mediports, and >1 lumen. AML was a CLABSI-specific risk. CLANC-specific risks included non–brain-tumor diagnosis, younger age at diagnosis or central-line placement, and age <1 year at diagnosis or line placement. Multivariable risks were for CLABSI >1 lumen and for CLANC age <1 year at placement. CONCLUSIONS: Among patients with CVCs, CLABSI and CLANC rates were similar, higher among inpatients than outpatients. For both CLABSIs and CLANCs, infants and patients with AML were at higher risk. In both univariate and multivariate models, lines with >1 lumen were associated with CLABSIs and placement during infancy with CLANCs.
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spelling pubmed-100152642023-03-16 Central-line–associated bloodstream infections and central-line–associated non-CLABSI complications among pediatric oncology patients Kelada, Aml S. Foster, Timothy B. Gagliano, Gregory C. Worley, Sarah Tang, Anne Arakoni, Venkatraman A. Foster, Charles B. Infect Control Hosp Epidemiol Original Article OBJECTIVE: To assess central venous catheter (CVC) harm in pediatric oncology patients, we explored risks for central-line–associated bloodstream infections (CLABSIs) and central-line–associated non-CLABSI complications (CLANCs). DESIGN: Retrospective cohort study. SETTING: Midwestern US pediatric oncology program. PATIENTS: The study cohort comprised 592 pediatric oncology patients seen between 2006 and 2016. METHODS: CLABSIs were defined according to Centers for Disease Control and Prevention (CDC)/National Health Safety Network (NHSN) definitions. CLANCs were classified using a novel definition requiring CVC removal. Patient-level and central-line–level risks were calculated using a negative binomial model to adjust for correlations between total events and line numbers. RESULTS: CVCs were inserted in 62% of patients, with 175,937 total catheter days. The inpatient CLABSI and CLANC rates were 5.8 and 8.5 times higher than outpatient rates. At the patient level, shared risks included acute myeloid leukemia (AML) and age <1 year at diagnosis. At the line level, shared risks included age <1 year at diagnosis, non-mediports, and >1 lumen. AML was a CLABSI-specific risk. CLANC-specific risks included non–brain-tumor diagnosis, younger age at diagnosis or central-line placement, and age <1 year at diagnosis or line placement. Multivariable risks were for CLABSI >1 lumen and for CLANC age <1 year at placement. CONCLUSIONS: Among patients with CVCs, CLABSI and CLANC rates were similar, higher among inpatients than outpatients. For both CLABSIs and CLANCs, infants and patients with AML were at higher risk. In both univariate and multivariate models, lines with >1 lumen were associated with CLABSIs and placement during infancy with CLANCs. Cambridge University Press 2023-03 2022-04-27 /pmc/articles/PMC10015264/ /pubmed/35475427 http://dx.doi.org/10.1017/ice.2022.91 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Kelada, Aml S.
Foster, Timothy B.
Gagliano, Gregory C.
Worley, Sarah
Tang, Anne
Arakoni, Venkatraman A.
Foster, Charles B.
Central-line–associated bloodstream infections and central-line–associated non-CLABSI complications among pediatric oncology patients
title Central-line–associated bloodstream infections and central-line–associated non-CLABSI complications among pediatric oncology patients
title_full Central-line–associated bloodstream infections and central-line–associated non-CLABSI complications among pediatric oncology patients
title_fullStr Central-line–associated bloodstream infections and central-line–associated non-CLABSI complications among pediatric oncology patients
title_full_unstemmed Central-line–associated bloodstream infections and central-line–associated non-CLABSI complications among pediatric oncology patients
title_short Central-line–associated bloodstream infections and central-line–associated non-CLABSI complications among pediatric oncology patients
title_sort central-line–associated bloodstream infections and central-line–associated non-clabsi complications among pediatric oncology patients
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10015264/
https://www.ncbi.nlm.nih.gov/pubmed/35475427
http://dx.doi.org/10.1017/ice.2022.91
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