Surveillance with successful reduction of central line-associated bloodstream infections among neutropenic patients with hematologic or oncologic malignancies

A team-based multidisciplinary approach to managing peripherally inserted central catheter complications in high-risk haematological patients: a prospective study

“…Moreover, our results of CRBSI are similar to previous studies of PICCs (Table 4) and tunnelled (3 %, 2.2/1000 catheter days) [3] and non-tunnelled-CVCs (16 %, 10.27/1000 catheter days) [2] in HM. The main risk factors for CRBSI in patients with HM are severe neutropenia (ANC <0.5×10 9 /L) at the time of catheter insertion [23], acute myeloid leukaemia receiving induction or consolidation therapy and previous invasive fungal disease [2,24]. In our series, the incidence of CRBSI was too low to draw any conclusions.…”

Impact of Switching from an Open to a Closed Infusion System on Rates of Central Line–Associated Bloodstream Infection: A Meta-analysis of Time-Sequence Cohort Studies in 4 Countries

“…34 Prospective studies in the Western industrialized countries have shown that hospitals that take a multidisciplinary systematic approach to the management of central lines within ICUs have achieved striking reductions in the incidence of CLABSI. [35][36][37][38][39][40] Such an approach focuses on education of all personnel who insert and care for central lines, limits insertions in the femoral vein, mandates maximal sterile barriers during catheter insertion, mandates disinfection of catheter insertion sites with tincture of chlorhexidine rather than iodine-based antiseptics, mandates proactive removal of unneeded catheters, and provides feedback surveillance of CLABSI rates.…”

Management of sepsis in neutropenic patients: 2014 updated guidelines from the Infectious Diseases Working Party of the German Society of Hematology and Medical Oncology (AGIHO)

“…Patients with solid tumours develop febrile neutropenia in around 10–40 %, but this complication might occur in more than 80 % of patients with haematological malignancies [1, 54]. In patients with indwelling central venous catheters (CVC), febrile neutropenia is frequently caused by catheter-related or catheter-associated bacteraemia with an incidence of around 10–20/1,000 neutropenic days [16, 34]. Likewise, translocation of gut organisms, such as vancomycin-resistant enterococci (VRE), may cause bacteraemia and, ultimately, sepsis in neutropenic cancer patients in up to 40 % of colonized patients [30, 101, 154].…”