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Central venous catheter salvage in children with Staphylococcus aureus central line-associated bloodstream infection

Kristine S Corkum1,2, Rachel E Jones3, Caroline H Reuter3,4

  • 1Feinberg School of Medicine, Northwestern University, Chicago, USA. kristine.corkum@northwestern.edu.

Pediatric Surgery International
|September 27, 2017
PubMed

Insights

Central venous catheter (CVC) salvage is a feasible option for children with Staphylococcus aureus bloodstream infections (CLABSI). This approach was not linked to increased complications or mortality, offering a viable alternative to immediate CVC removal.

Area of Science:

  • Pediatric Infectious Diseases
  • Critical Care Medicine
  • Medical Device Management

Background:

  • Current guidelines recommend prompt central venous catheter (CVC) removal for pediatric Staphylococcus aureus central line-associated bloodstream infections (CLABSI).
  • Limited data exists on the outcomes of attempting CVC salvage in this population.

Purpose of the Study:

  • To evaluate the success of attempted CVC salvage in children diagnosed with S. aureus CLABSI.
  • To identify potential predictors associated with CVC salvage failure.

Main Methods:

  • Retrospective cohort study of pediatric patients with S. aureus CLABSI from 2012-2015.
  • Comparison of outcomes between patients undergoing immediate CVC removal (≤2 days) and those with attempted CVC salvage.
  • Primary outcome defined as CVC salvage failure (removal >3 days after initial positive culture).

Main Results:

  • Of 77 children with S. aureus CLABSI, 72.7% underwent attempted CVC salvage.
  • Successful CVC salvage was achieved in 78.6% of attempted cases; 21.4% required delayed removal.
  • Malignancy, short gut syndrome, neutropenia, MRSA, and line type did not predict salvage failure.
  • No significant morbidity or mortality was observed in patients with failed salvage attempts.

Conclusions:

  • Central venous catheter salvage is a feasible strategy in the majority of pediatric S. aureus CLABSI cases.
  • CVC salvage in children did not appear to be associated with significant complications or mortality.
  • Findings suggest a potential shift from mandatory CVC removal in certain pediatric CLABSI scenarios.
Abstract

Keywords:
CLABSICentral venous catheterChildrenS. aureusSalvage

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