A Local Experience of Antibiotic Lock Therapy as an Adjunctive Treatment for Central Venous Catheter-Related Bloodstream Infections in Pediatric Oncology and Hematology Patients

• Published in: Children (Basel) Vol. 11; no. 8; p. 983
• Main Authors: de Frutos Porras, Elena, Cobo-Vázquez, Elvira, Hernanz Lobo, Alicia, Santos Sebastián, María Del Mar, Pérez Fernández, Elia, Garrido Colino, Carmen, Cela, Elena, Navarro Gómez, María Luisa
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 01.08.2024; MDPI
• Subjects: antibiotic lock therapy; Antibiotics; Anticoagulants; Bacteria; Cancer; catheter-related bloodstream infection; Catheterization; Catheters; central venous catheter; Chemotherapy; Fungal infections; Health aspects; Hematology; Hospitals; Medical history; Medical prognosis; Medical records; Mortality; Neutropenia; Nosocomial infections; Oncology; Parenteral nutrition; Patients; pediatric; Pediatrics; Venous access; Spain; catheter-related bloodstream infection; hematology; antibiotic lock therapy; central venous catheter; oncology; pediatric
• ISSN: 2227-9067; 2227-9067
• DOI: 10.3390/children11080983

One of the main drawbacks of tunneled central venous catheters (CVCs) is catheter-related bloodstream infections (CRBSIs). Antibiotic lock therapy (ALT) can be combined with systemic antibiotics to achieve catheter salvage. Our objectives are to describe cases of CRBSI and our experience with ALT in a pediatric oncology-hematology ward. a retrospective descriptive study of pediatric CRBSI cases in a Spanish oncology-hematology unit from 2007 to 2017 was conducted. We collected demographic, clinical, and microbiological data from all patients. fifty-eight CRBSIs were diagnosed in thirty-nine patients; 72.9% of these patients were male, with a median age of 42.1 months. The main underlying diseases were leukemia/lymphoma (51.7%) and solid tumors (32.7%). Thirty-five (60.3%) CRBSIs were caused by Gram-positive cocci, of which 70.6% were coagulase-negative , and sixteen (27.6%) were caused by Gram-negative bacilli. We treated 41/58 (71%) cases with ALT. A total of 12/17 (71%) CVCs that were not treated with adjunctive ALT were removed, compared with 13/41 (32%) that were treated with ALT (relative risk (RR), 0.449; confidence interval (CI), 95%: 0.259-0.778, = 0.004). Major reasons to remove the CVC in the CRBSI-ALT group were local insertion/pocket site infection (23%), persistent symptoms (23%), and infectious' relapses (15%). ALT was shown to be an effective approach to keeping the CVC in place, with no added adverse effects.