EP371 - CENTRAL LINE-ASSOCIATED BLOODSTREAM INFECTIONS (CLABSIS) IN PEDIATRIC ONCOLOGY PATIENTS (ID 1533)
Abstract
Backgrounds:
The aim of this study was to review central line associated bloodstream infections (CLABSIs) in children with cancer.
Methods
This was a retrospective study conducted in a 20-bed pediatric oncology department from 1/1/2019 to 15/7/2021. CDC criteria for CLABSI definition were used. Bacterial identification antimicrobial susceptibility testing were done with the automated Vitek II system.
Results:
Among hospitalized children 22 patients had 27 CLABSI episodes. In all but one case, the culture was taken from a Central Venous Catheter (CVC). The prevalence of CLABSIs was 36.5%, higher in leukemias (57.1%). Among CLABSI episodes, 26 blood cultures were positive for bacterial pathogens, and one for fungus (Candida parapsilosis). Eleven different species of bacteria were isolated, with a predominance of Gram negative (17/27 63%). The most common bacteria were Staphylococcus epidermidis (6/27), followed by Pseudomonas aeruginosa (5/27), Escherichia coli (4/27) and Klebsiella pneumoniae (3/27). The mean CRP values in CLABSI cases was 113 mg/L, while in 38.5% of episodes it was > 100 mg/L. Neutropenia was reported in 67% of episodes at diagnosis, which in 52% of cases was severe. In 41% of cases the absolute neutrophil count was <0.1 k/μL. Antimicrobial susceptibility testing showed that 37.5% of the enterobacteriales isolated produced broad-spectrum β-lactamases, while 83% of Staphylococcus epidermidis were resistant to oxacillin. Mortality was 7.4%. CRP values in survivors were statistically significantly lower (p< 0.001) than those who deceased.
Conclusions/Learning Points:
The prevalence of CLABSIs in our pediatric oncology patients is high. CLABSIs usually present with fever accompanied by neutropenia and high CRP. Gram (-) bacteria are the most common pathogens of CLABSIs. Knowledge of the epidemiology of CLABSIs is essential, as it is a commonly potentially life- threatening condition in pediatric cancer patients.
