Kristine S Corkum1,2, Rachel E Jones3, Caroline H Reuter3,4, Larry K Kociolek3,4, Elaine Morgan3,5, Timothy B Lautz3,6. 1. Feinberg School of Medicine, Northwestern University, Chicago, USA. kristine.corkum@northwestern.edu. 2. Division of Pediatric Surgery, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, USA. kristine.corkum@northwestern.edu. 3. Feinberg School of Medicine, Northwestern University, Chicago, USA. 4. Division of Infectious Diseases, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, USA. 5. Division of Hematology and Oncology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, USA. 6. Division of Pediatric Surgery, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, USA.
Abstract
BACKGROUND: Prompt central venous catheter (CVC) removal is currently recommended in children with Staphylococcus aureus central line-associated bloodstream infection (CLABSI). Our objective was to examine the outcome of attempted line salvage in children with S. aureus CLABSI and assess predictors of success. METHODS: A single-institution, retrospective cohort study was performed of all children with S. aureus CLABSI between 2012 and 2015. Patients with and without immediate CVC removal (≤ 2 days after first positive culture) were compared. The primary outcome was failed CVC salvage (removal after 3+ days). RESULTS: Seventy-seven children met criteria for S. aureus CLABSI. Immediate CVC removal was performed in 27.3% of patients. Among the 72.7% patients in whom CVC salvage was attempted, 78.6% were successful and 21.4% required delayed CVC removal. Malignancy, short gut syndrome, neutropenia, methicillin-resistant S. aureus, and line type were not associated with salvage failure. No associated morbidity or mortality occurred in patients with a failed salvage attempt. New or recurrent bacteremia occurred in five patients, but three were successfully salvaged a second time. CONCLUSIONS: CVC salvage was feasible in the majority of children with S. aureus CLABSI and was not associated with significant complications or attributable mortality as reported in adults.
BACKGROUND: Prompt central venous catheter (CVC) removal is currently recommended in children with Staphylococcus aureus central line-associated bloodstream infection (CLABSI). Our objective was to examine the outcome of attempted line salvage in children with S. aureus CLABSI and assess predictors of success. METHODS: A single-institution, retrospective cohort study was performed of all children with S. aureus CLABSI between 2012 and 2015. Patients with and without immediate CVC removal (≤ 2 days after first positive culture) were compared. The primary outcome was failed CVC salvage (removal after 3+ days). RESULTS: Seventy-seven children met criteria for S. aureus CLABSI. Immediate CVC removal was performed in 27.3% of patients. Among the 72.7% patients in whom CVC salvage was attempted, 78.6% were successful and 21.4% required delayed CVC removal. Malignancy, short gut syndrome, neutropenia, methicillin-resistant S. aureus, and line type were not associated with salvage failure. No associated morbidity or mortality occurred in patients with a failed salvage attempt. New or recurrent bacteremia occurred in five patients, but three were successfully salvaged a second time. CONCLUSIONS: CVC salvage was feasible in the majority of children with S. aureus CLABSI and was not associated with significant complications or attributable mortality as reported in adults.
Entities:
Keywords:
CLABSI; Central venous catheter; Children; S. aureus; Salvage
Authors: J Chase McNeil; Kristina G Hulten; Sheldon L Kaplan; Donald H Mahoney; Edward O Mason Journal: Pediatr Infect Dis J Date: 2013-02 Impact factor: 2.129
Authors: Anna Lisa Crowley; Gail E Peterson; Daniel K Benjamin; Susan H Rimmer; Cindy Todd; Christopher H Cabell; L Barth Reller; Thomas Ryan; G Ralph Corey; Vance G Fowler Journal: Crit Care Med Date: 2008-02 Impact factor: 7.598
Authors: Yinin Hu; Christopher A Guidry; Bartholomew J Kane; Eugene D McGahren; Bradley M Rodgers; Robert G Sawyer; Sara K Rasmussen Journal: J Pediatr Surg Date: 2015-11-06 Impact factor: 2.545