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Instituting a New Central Line Policy to Decrease Central Line-associated Blood Stream Infection Rates During Induction Therapy in Pediatric Acute Lymphoblastic Leukemia Patients. J Pediatr Hematol Oncol 2020 Oct;42(7):433-437

Date

02/19/2020

Pubmed ID

32068652

DOI

10.1097/MPH.0000000000001748

Scopus ID

2-s2.0-85081297549 (requires institutional sign-in at Scopus site)   5 Citations

Abstract

BACKGROUND: Children with acute lymphoblastic leukemia (ALL) require central lines to facilitate their care. Peripherally inserted central catheters (PICCs) may have lower rates of central line-associated bloodstream infections (CLABSIs) versus other central lines.

OBJECTIVES: The objective of this study was to compare the CLABSI rate in the first month of therapy after initiating a policy to place PICCs in new patients with severe neutropenia (SN) and Mediports in those with moderate-to-no neutropenia. We also examined thrombosis rates.

DESIGN/METHOD: We prospectively gathered data on new patients for 2.5 years following the policy change and retrospectively for the 2 years prior and compared rates of CLABSIs and thrombosis.

RESULTS: CLABSIs decreased in SN patients from 7.52/1000 to 3.11/1000 line days (P=0.33). The CLABSI rate for all patients with SN who had a Mediport was 13.39/1000 versus 4.08/1000 line days for those that received PICCs (P=0.15). The thrombosis rate for Mediport patients was 3.13 clots/1000 versus 7.65/1000 line days for PICC patients, but the difference was not significant (P= 0.11).

CONCLUSION: The differences observed suggest that placing PICCs versus Mediports in new ALL patients with SN may result in a lower incidence of CLABSIs in the first month of therapy without a significant increase in thrombosis.

Author List

Berger R, Messina AF, Chandler NM, Amankwah EK, Shaw PH

Author

Peter H. Shaw MD Professor in the Pediatrics department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Adolescent
Adult
Bacteremia
Baltimore
Catheterization, Central Venous
Central Venous Catheters
Child
Child, Preschool
Female
Follow-Up Studies
Health Policy
Humans
Incidence
Infant
Male
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Prognosis
Prospective Studies
Retrospective Studies
Risk Factors
Survival Rate
Young Adult