Related Experiment Video
Updated: Oct 18, 2025
Neutrophil Lifespan Extension with CLON-G and an In Vitro Spontaneous Death Assay
Published on: May 12, 2023
Postoperative Rather Than Preoperative Neutropenia Is Associated With Early Catheter-related Bloodstream Infections
Wen Qi Cher1, Vanessa Lee2, Rachel Wang2
1Department of Pediatric Medicine, KK Women's and Children's Hospital, Singapore.
Insights
Pediatric cancer patients with prolonged neutropenia after surgery face higher risks of catheter-related bloodstream infections (CRBSIs). Empirical preoperative antibiotics are not recommended; focus on managing postoperative neutropenia to prevent CRBSIs.
Area of Science:
- Pediatric Oncology
- Infectious Diseases
- Hematology
Background:
- The link between early catheter-related bloodstream infections (CRBSIs) and perioperative neutropenia or antibiotic prophylaxis in pediatric cancer patients is unclear.
- Investigating perioperative factors, including hematologic indices and antibiotic use, is crucial for understanding early CRBSI development.
Purpose of the Study:
- To evaluate perioperative factors associated with early CRBSIs in newly diagnosed pediatric cancer patients.
- To specifically examine the role of hematologic indices and antibiotic use in early CRBSI development.
Main Methods:
- Retrospective review of national registry data for pediatric cancer patients with port-a-caths.
- Standardized perioperative protocols were used, with antibiotic use being unregulated.
- Logistic regression and linear trend analysis correlated 30-day CRBSI incidence with preoperative factors and postoperative blood counts.
Main Results:
- 17 CRBSIs (7.0%) occurred in 243 patients within 30 days post-surgery.
- Early CRBSIs were significantly associated with cancer type (AML/OLs vs. STLs; OR 5.09) but not preoperative antibiotics or initial neutrophil/WBC counts.
- Patients with acute myeloid leukemia/other leukemias (AML/OLs) experienced more prolonged neutropenia postoperatively compared to solid tumors and lymphomas (STLs).
Conclusions:
- Low preoperative neutrophil counts and lack of preoperative antibiotics did not increase early CRBSI risk.
- Patients with AML/OLs, especially those with prolonged postoperative neutropenia, showed a higher risk of early CRBSIs.
- Findings do not support empirical preoperative antibiotics; prolonged postoperative neutropenia is a key factor for early CRBSI.
Background:
The relationship of early catheter-related bloodstream infections (CRBSIs) with perioperative neutropenia and antibiotic prophylaxis is not well established. We sought to evaluate perioperative factors associated with early CRBSIs in newly diagnosed pediatric cancer patients, particularly hematologic indices and antibiotic use.
Methods:
We retrospectively reviewed national registry records of newly diagnosed pediatric cancer patients with port-a-caths inserted using standardized perioperative protocols where only antibiotic use was not regulated. Thirty-day postoperative CRBSI incidence was correlated with preoperative factors using logistic regression and with postoperative blood counts using linear trend analysis.
Results:
Among 243 patients, 17 CRBSIs (7.0%) occurred at median 14 (range, 8-28) postoperative days. Early CRBSIs were significantly associated with cancer type [acute myeloid leukemia and other leukemias (AML/OLs) vs. solid tumors and lymphomas (STLs): odds ratio (OR), 5.09; P = 0.0036; acute lymphoblastic leukemia vs. STL: OR 0.83; P = 0.0446] but not preoperative antibiotics, absolute neutrophil counts and white blood cell counts. Thirty-day postoperative absolute neutrophil counts and white blood cell trends differed significantly between patients with acute lymphoblastic leukemia and STLs (OR 0.83, P < 0.05) and between AML/OLs and STLs (OR 5.09, P < 0.005), with AML/OL patients having the most protracted neutropenia during this period.
Conclusions:
Contrary to common belief, low preoperative absolute neutrophil counts and lack of preoperative antibiotics were not associated with higher early CRBSI rates. Instead, AML/OL patients, particularly those with prolonged neutropenia during the first 30 postoperative days, were at increased risk. Our findings do not support the use of empirical preoperative antibiotics and instead identify prolonged postoperative neutropenia as a major contributing factor for early CRBSI.
More Related Videos
Related Concept Videos
01:16Kidney Transplant III: Nursing Management
01:28Cardiac Catheterization I: Pre-Procedure Overview
01:27Parentral Nutrition: Centeral and Peripheral Parental Nutrition
PN can be administered through two primary routes:
1. Central Parenteral Nutrition (CPN):
CPN involves delivering a high concentration of nutrients through a large vein. This is typically achieved using a Peripherally Inserted Central Catheter (PICC) or,...
01:26Kidney Transplant II: Surgical Procedure
01:26Cardiac Catheterization IV: Nursing Management
01:22Aneurysm IV: Nursing Management