BACKGROUND: Risk factors for central line-associated bloodstream infections (CLABSI) among children with cancer in the outpatient setting remain poorly defined, and the microbiology may differ from hospital-onset CLABSI. MATERIALS AND METHODS: We conducted a matched case-control study of oncology patients followed at the Dana Farber/Children's Hospital Cancer Center. Cases (N=41) were patients with CLABSI as per National Healthcare Safety Network criteria who had not been hospitalized in the preceding 48 hours. For each case we randomly selected 2 oncology outpatients with a central venous catheter and a clinic visit within 30 days of the case subject's CLABSI. Multivariate conditional logistic regression models were used to identify independent risk factors for CLABSI. We compared the microbiology to that of 54 hospital-onset CLABSI occurring at our institution during the study period. RESULTS: Independent predictors of community-onset CLABSI included neutropenia in the prior week (odds ratio 17.46; 95% confidence interval, 4.71-64.67) and tunneled externalized catheter (vs. implantable port; odds ratio 10.30; 95% confidence interval, 2.42-43.95). Nonenteric gram-negative bacteria were more frequently isolated from CLABSI occurring among outpatients. DISCUSSION: Pediatric oncology outpatients with recent neutropenia or tunneled externalized catheters are at increased risk of CLABSI. The microbiology of community-onset CLABSI differs from hospital-onset CLABSI.
BACKGROUND: Risk factors for central line-associated bloodstream infections (CLABSI) among children with cancer in the outpatient setting remain poorly defined, and the microbiology may differ from hospital-onset CLABSI. MATERIALS AND METHODS: We conducted a matched case-control study of oncology patients followed at the Dana Farber/Children's Hospital Cancer Center. Cases (N=41) were patients with CLABSI as per National Healthcare Safety Network criteria who had not been hospitalized in the preceding 48 hours. For each case we randomly selected 2 oncology outpatients with a central venous catheter and a clinic visit within 30 days of the case subject's CLABSI. Multivariate conditional logistic regression models were used to identify independent risk factors for CLABSI. We compared the microbiology to that of 54 hospital-onset CLABSI occurring at our institution during the study period. RESULTS: Independent predictors of community-onset CLABSI included neutropenia in the prior week (odds ratio 17.46; 95% confidence interval, 4.71-64.67) and tunneled externalized catheter (vs. implantable port; odds ratio 10.30; 95% confidence interval, 2.42-43.95). Nonenteric gram-negative bacteria were more frequently isolated from CLABSI occurring among outpatients. DISCUSSION: Pediatric oncology outpatients with recent neutropenia or tunneled externalized catheters are at increased risk of CLABSI. The microbiology of community-onset CLABSI differs from hospital-onset CLABSI.
Authors: Samir S Shah; Mary Lou Manning; Elizabeth Leahy; Mark Magnusson; Susan R Rheingold; Louis M Bell Journal: Infect Control Hosp Epidemiol Date: 2002-02 Impact factor: 3.254
Authors: Theresa L Smith; Gregg T Pullen; Vonda Crouse; Jon Rosenberg; William R Jarvis Journal: Infect Control Hosp Epidemiol Date: 2002-05 Impact factor: 3.254
Authors: Naomi P O'Grady; Mary Alexander; E Patchen Dellinger; Julie L Gerberding; Stephen O Heard; Dennis G Maki; Henry Masur; Rita D McCormick; Leonard A Mermel; Michele L Pearson; Issam I Raad; Adrienne Randolph; Robert A Weinstein Journal: MMWR Recomm Rep Date: 2002-08-09
Authors: Sean M Berenholtz; Peter J Pronovost; Pamela A Lipsett; Deborah Hobson; Karen Earsing; Jason E Farley; Shelley Milanovich; Elizabeth Garrett-Mayer; Bradford D Winters; Haya R Rubin; Todd Dorman; Trish M Perl Journal: Crit Care Med Date: 2004-10 Impact factor: 7.598
Authors: Steven S Spires; Peter F Rebeiro; Mickie Miller; Katie Koss; Patty W Wright; Thomas R Talbot Journal: Infect Control Hosp Epidemiol Date: 2018-02-15 Impact factor: 3.254
Authors: Simone de Campos Vieira Abib; Chan Hon Chui; Sharon Cox; Abdelhafeez H Abdelhafeez; Israel Fernandez-Pineda; Ahmed Elgendy; Jonathan Karpelowsky; Pablo Lobos; Marc Wijnen; Jörg Fuchs; Andrea Hayes; Justin T Gerstle Journal: Ecancermedicalscience Date: 2022-02-17
Authors: Maziar M Nourian; Angelina L Schwartz; Austin Stevens; Eric R Scaife; Brian T Bucher Journal: J Pediatr Surg Date: 2017-12-24 Impact factor: 2.545