Antibiotic and other lock treatments for tunnelled central venous catheter related infections in children with cancer

Schoot, Reineke A.; Dalen, Elvira C. van; Ommen, Heleen van; Wetering, Marianne D. van de

doi:10.1002/14651858.cd008975

Cited by 6 publications

(4 citation statements)

References 33 publications

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“…A significant correlation was reported between the occurrence of catheterrelated bacteremia and the duration of catheterization. Many authors have come to the same conclusion for catheter-related bacteremias [25,27,28]. Merrer [27] explains this fact by the multiplication of potentially septic manipulations from the connector (faucets, infusions …).…”

Section: Discussionmentioning

confidence: 90%

High Prevalence of Multidrug-Resistant Bacteria in the Centre Hospitalier et Universitaire de la Mère et de l’Enfant Lagune (CHU-MEL) Reveals Implications of Poor Hygiene Practices in Healthcare

Dougnon

Koudokpon

Hounmanou

et al. 2019

SN Compr. Clin. Med.

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Healthcare-associated infections represent an emerging public health issue with serious impact among hospitalized patients, including cesarized women and children with catheter. The present study determined the implications of hygiene practices and the hospital environment in wound reinfection among cesarized women and the occurrence of catheter-induced infections in children. Bacteriological analyses were performed on 100 wound swabs from cesarized women, 40 swabs from the wound dressing room, and 83 catheter tips used in children. Isolated bacteria were tested for antimicrobial susceptibility. A comparison of the resistance profile between strains isolated from wounds and those isolated from the dressing room was conducted, whereas the hygiene practices observed from the personnel during catheter removal were recorded in the case of children. The results show that 85% of wound swabs, 63% of swabs from the dressing room, and 33.7% of catheter tips were positive for bacteriological analysis. The most isolated strains in wound and environmental swabs were Staphylococcus aureus (56%) and coagulasenegative Staphylococcus (44%), followed by Klebsiella pneumoniae (30%) and Enterobacter cloacae (32%) for wounds and Escherichia coli (43%) and Klebsiella pneumoniae (28%) for the environment. The catheter tips contained mostly Klebsiella pneumoniae (32%), coagulase-negative Staphylococcus (25%), and Enterobacter cloacae (14%). All strains showed resistance to penicillin and cephalosporin. The comparison of the resistance profiles suggests an implication of the environmental strains in the reinfection of wounds in cesarized women. However, a significant correlation was recorded between poor hygiene practices and the contamination of the catheter tips. These findings allowed the authorities of this hospital to reinforce the knowledge and improve the hygiene management, in order to still hold the good label of the structure.

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Section: Discussionmentioning

confidence: 90%

High Prevalence of Multidrug-Resistant Bacteria in the Centre Hospitalier et Universitaire de la Mère et de l’Enfant Lagune (CHU-MEL) Reveals Implications of Poor Hygiene Practices in Healthcare

Dougnon

Koudokpon

Hounmanou

et al. 2019

SN Compr. Clin. Med.

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“…Studies incorporating different patient populations were only included if the text outlined that patients on parenteral nutrition were included. Studies only containing children were excluded in order to limit the heterogeneity of the patient population and because of expected differences in CRBSI etiology, diagnosis, and management ( 22 , 23 ). When distinct publications had partly overlapping data due to the same patients’ inclusion, the results were either combined or collected from the most extensive study to avoid duplicate data.…”

Section: Methodsmentioning

confidence: 99%

Comparing success rates in central venous catheter salvage for catheter-related bloodstream infections in adult patients on home parenteral nutrition: a systematic review and meta-analysis

Gompelman

Paus

Bond

et al. 2021

The American Journal of Clinical Nutrition

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Background Catheter-related bloodstream infection (CRBSI) is a life-threatening complication of parenteral nutrition. Therefore, optimal management, ideally with catheter salvage, is required to maintain long-term venous access. Objectives We aimed to evaluate successful catheter salvage rates in patients on home parenteral nutrition (HPN). Methods Studies were retrieved from medical databases, conference proceedings, and article reference lists. Data were collected relating to clinical outcomes of 3 treatments: systemic antibiotics, antimicrobial lock therapy (ALT), and catheter exchange. ORs and 95% CIs were calculated from a mixed logistic effects model. Results From 10,036 identified publications, 28 met the inclusion criteria (22 cohort studies, 5 case-control studies, and 1 randomized clinical trial), resulting in a total of 4911 CRBSIs. To achieve successful catheter salvage, the addition of an antimicrobial lock solution was superior to systemic antibiotics alone (OR: 1.75; 95% CI: 1.21, 2.53; P = 0.003). Recurrence of infection was less common in studies that used ALT than in those that used systemic antibiotics alone (OR: 0.26; 95% CI: 0.11, 0.61; P = 0.002). The catheter exchange group was excluded from multilevel regression analysis because only 1 included study applied this treatment. Successful salvage rates were highest for coagulase-negative staphylococci, followed by Gram-negative rods and Staphylococcus aureus . Conclusions The addition of an antimicrobial lock solution seems beneficial for successful catheter salvage in HPN-dependent patients with a CRBSI. Future prospective randomized studies should identify the most effective and pathogen-specific strategy. This review was registered at www.crd.york.ac.uk/PROSPERO as CRD42018102959.

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“…None of these actions have single handily contributed to an overall pronounced effect and the use of systemic antibiotics as well as antibiotic impregnated catheters is not routinely recommended. However, combining the previous mentioned approaches with a number of contributing factors (bundle strategy) such as the use of systematic site disinfection (eg, chlorhexidine 2% in alcohol), focus on hand hygiene and sterile techniques when using CVCs has had the most pronounced impact 6,19‐22 . The subject of CLABSI is comprehensive and will therefore not be covered in full details in this review.…”

Section: Whatmentioning

confidence: 99%

Long‐term IV access in paediatrics ‐ why, what, where, who and how

Johansen

Classen

Muchantef

2020

Acta Anaesthesiol Scand

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Establishment of long‐term central venous access imposes the risk of procedural adverse events (air embolism, pneumothorax, accidental arterial cannulation of the great vessels, tricuspid valve damage and cardiac tamponade) as well as the risk of increased morbidity and mortality due to catheter related blood stream infections, vessel stenosis, deep vein thrombosis and the often high risk anaesthetic management of syndromic children. This narrative review aims to provide a historical and clinical background for the development and use of CVADs (central venous access devices), origin and management of the most common complications (catheter related thrombosis, infections and persistent withdrawal occlusion) and present the reader with an update on the “why, what, where, who and how” in paediatric long‐term central venous access. Finally, we will present the reader with a clinical method for applying a retrograde inserted tunnelled and cuffed catheter using the left brachiocephalic vein access.

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Antibiotic and other lock treatments for tunnelled central venous catheter related infections in children with cancer

Cited by 6 publications

References 33 publications

High Prevalence of Multidrug-Resistant Bacteria in the Centre Hospitalier et Universitaire de la Mère et de l’Enfant Lagune (CHU-MEL) Reveals Implications of Poor Hygiene Practices in Healthcare

High Prevalence of Multidrug-Resistant Bacteria in the Centre Hospitalier et Universitaire de la Mère et de l’Enfant Lagune (CHU-MEL) Reveals Implications of Poor Hygiene Practices in Healthcare

Comparing success rates in central venous catheter salvage for catheter-related bloodstream infections in adult patients on home parenteral nutrition: a systematic review and meta-analysis

Long‐term IV access in paediatrics ‐ why, what, where, who and how

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