Central venous catheter-related infections in pediatric hematology-oncology patients: role of home and hospital management.

In a 61-month period, 135 single-lumen central venous catheters (CVCs) were positioned in 125 children with mainly hematological malignancies. We retrospectively investigated the different role of home and hospital CVC management in development of CVC-related infections (CI) during different hematological conditions (presence or absence of neutropenia). Forty-nine percent of the children presented at least one CI, for a total of 109 episodes, during the 20,558 days a CVC remained in situ. CVC hospital management was safer and more reliable than CVC home management in both neutropenic and nonneutropenic patients. None of the CI was life threatening and only in 11% of the cases was it necessary to remove the catheter. Analysis of the microorganisms involved showed that they were mainly gram-positive with CVC home management and gram-negative with CVC hospital management. Careful evaluation of our retrospective survey study suggests that a better training of parents in the care of the CVC and more careful measures of asepsis in hospital could further decrease the incidence of CI, thus improving patients' quality of life.