Related Experiment Video
Updated: Jul 9, 2025
Author Spotlight: Enhancing Candida albicans Detection in Catheter Infections Using Fluorescent Protein Tagging
Published on: March 22, 2024
Early Central Venous Catheter Replacement After Candida in Pediatric Intestinal Failure Patients
Daphna Katz1,2, Natalia Jelen2, Alana Xavier de Almeida2
1From the Division of Pediatric Gastroenterology, Hepatology and Nutrition, University of Miami, Miami, FL.
Insights
Early central venous catheter (CVC) replacement in children with intestinal failure (IF) after candidemia shortens hospital stays. This approach is safe, reducing hospitalization duration without increasing readmission or reinfection risks.
Area of Science:
- Pediatric Gastroenterology
- Infectious Diseases
- Critical Care Medicine
Background:
- Children with intestinal failure (IF) face risks from central venous catheter (CVC) complications.
- Deferred CVC replacement after candidemia can lead to adverse events.
Purpose of the Study:
- To evaluate the safety and benefits of early CVC replacement following uncomplicated candidemia in pediatric IF patients.
- To compare outcomes between early and late CVC replacement strategies.
Main Methods:
- Retrospective review of pediatric IF patients.
- Categorization into early (<7 days) and late (≥7 days) CVC replacement groups post-candidemia.
- Analysis of time to CVC removal, infection clearance, CVC replacement/exchange, hospitalization duration, and 30-day readmission rates.
Main Results:
- Early CVC replacement showed a median time to replacement of 4 days versus 10 days for late replacement (P < 0.001).
- Hospitalization duration was significantly shorter in the early group (12 days) compared to the late group (21 days) (P = 0.011).
- No significant difference in 30-day readmission rates (39% vs. 57%) or candida reinfection was observed between groups.
Conclusions:
- Early CVC replacement after uncomplicated candidemia in children with IF is safe and effective.
- This strategy reduces hospital stay duration without compromising patient safety regarding readmission or reinfection.
Background:
Deferred central venous catheter (CVC) replacement places children with intestinal failure (IF) at risk of complications. We hypothesized that early CVC replacement after uncomplicated candidemia is safe and beneficial.
Methods:
We performed a retrospective review of children with IF. Patients were divided into early (<7 days after their first negative culture), and late (≥7 days after their first negative culture) CVC replacement following uncomplicated candidemia. We calculated the median time to CVC removal, clearance of infection, CVC replacement or exchange, and duration of the initial hospitalization. The proportion of patients readmitted within 30 days was also calculated, taking note of the number of candida reinfections.
Results:
Early replacement occurred in 18 encounters and late replacement in 21 encounters. The median time in both groups to CVC removal was 3 days (P = 0.949), and clearance of infection was 4 days (P = 0.466). The median time to CVC replacement or exchange in the early group was 4 days, compared to 10 days in the late group (P < 0.001). The median duration of the hospitalization in the early group was 12 days compared to 21 days in the late group (P = 0.011). In total 39% of patients from the early group were readmitted within 30 days compared to 57% from the late group (P = 0.359). None of the patients were reinfected with candida within 30 days.
Conclusion:
Early CVC replacement after uncomplicated candidemia in children with IF decreases hospital stay without increased risk of readmission or reinfection.
