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Central Venous Catheter Salvage in Ambulatory Central Line-Associated Bloodstream Infections.
- Source :
-
Pediatrics [Pediatrics] 2021 Dec 01; Vol. 148 (6). - Publication Year :
- 2021
-
Abstract
- Background: Guidelines for treatment of central line-associated bloodstream infection (CLABSI) recommend removing central venous catheters (CVCs) in many cases. Clinicians must balance these recommendations with the difficulty of obtaining alternate access and subjecting patients to additional procedures. In this study, we evaluated CVC salvage in pediatric patients with ambulatory CLABSI and associated risk factors for treatment failure.<br />Methods: This study was a secondary analysis of 466 ambulatory CLABSIs in patients <22 years old who presented to 5 pediatric medical centers from 2010 to 2015. We defined attempted CVC salvage as a CVC left in place ≥3 days after a positive blood culture result. Salvage failure was removal of the CVC ≥3 days after CLABSI. Successful salvage was treatment of CLABSI without removal of the CVC. Bivariate and multivariable logistic regression analyses were used to test associations between risk factors and attempted and successful salvage.<br />Results: A total of 460 ambulatory CLABSIs were included in our analysis. CVC salvage was attempted in 379 (82.3%) cases. Underlying diagnosis, CVC type, number of lumens, and absence of candidemia were associated with attempted salvage. Salvage was successful in 287 (75.7%) attempted cases. Underlying diagnosis, CVC type, number of lumens, and absence of candidemia were associated with successful salvage. In patients with malignancy, neutropenia within 30 days before CLABSI was significantly associated with both attempted salvage and successful salvage.<br />Conclusions: CVC salvage was often attempted and was frequently successful in ambulatory pediatric patients presenting with CLABSI.<br />Competing Interests: POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose.<br /> (Copyright © 2021 by the American Academy of Pediatrics.)
- Subjects :
- Adolescent
Ambulatory Care
Bacteremia microbiology
Candidemia epidemiology
Catheter-Related Infections microbiology
Child
Child, Preschool
Device Removal
Female
Hospitals, Pediatric
Humans
Infant
Infant, Newborn
Male
Regression Analysis
Retrospective Studies
Salvage Therapy statistics & numerical data
Time Factors
Treatment Failure
Treatment Outcome
Young Adult
Bacteremia therapy
Catheter-Related Infections therapy
Catheterization, Central Venous adverse effects
Central Venous Catheters adverse effects
Salvage Therapy methods
Subjects
Details
- Language :
- English
- ISSN :
- 1098-4275
- Volume :
- 148
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- Pediatrics
- Publication Type :
- Academic Journal
- Accession number :
- 34814175
- Full Text :
- https://doi.org/10.1542/peds.2020-042069