Central Line Associated Blood Stream Infections in Pediatric Hematology/Oncology Patients With Different Types of...

Area of Science:

• Pediatric Hematology/Oncology
• Infectious Disease Epidemiology
• Clinical Practice Guidelines

Background:

• Central line-associated bloodstream infections (CLABSIs) are a major cause of illness and death in pediatric hematology/oncology (PHO) patients.
• Understanding CLABSI rates across different central line (CL) types is crucial for optimizing patient care and reducing infection risk.

Purpose of the Study:

• To compare CLABSI rates among three common central line types: totally implanted catheters (ports), tunneled externalized catheters (TECs), and peripherally inserted central catheters (PICCs).
• To identify differences in CLABSI incidence between inpatient and ambulatory pediatric hematology/oncology patients across these central line types.

Main Methods:

• Prospective tracking of CLABSI events and central line days across 15 US PHO centers from May 2012 to April 2015.
• Calculation of CLABSI rates per 1,000 central line days for ports, TECs, and PICCs.
• Analysis of host and organism characteristics associated with CLABSI events.

Main Results:

• Over 2.8 million line days, 1,113 CLABSIs were recorded, with higher rates in inpatients versus ambulatory patients for all line types.
• Inpatient CLABSI rates: ports (1.48), TECs (3.51), PICCs (3.07). Ambulatory CLABSI rates: ports (0.16), TECs (1.38), PICCs (1.16).
• TECs and PICCs had higher CLABSI rates than ports in both inpatient and ambulatory settings.

Conclusions:

• CLABSI rates are significantly higher in inpatient PHO patients compared to ambulatory patients across all central line types.
• Among ambulatory patients, TECs had the highest CLABSI rate, while ports had the lowest.
• In inpatients, TECs and PICCs demonstrated higher CLABSI rates than ports, though not statistically different from each other, informing central line selection in clinical practice.