Journals / Turkish Journal of Pediatrics / 2021 / Cilt: 63 - Sayı: 1

Investigating the risk factors for antibiotic lock therapy failure in pediatric cancer: a single center retrospective analysis

Pages
86–94
DOI
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Future studies with larger sample sizes are needed to determine the factors affecting the ALT outcome, especially in childhood malignancies.

📌 3 Key Takeaways

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Objective & Hypothesis:Catheter-related bloodstream infection (CRBSI) is one of the most common complications of central lines.
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Key Findings & Data:All cases with CRBSI and treated with ALT administiration in children with cancer between January 2015 and May 2019 were reviewed.
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Conclusion & Impact:Future studies with larger sample sizes are needed to determine the factors affecting the ALT outcome, especially in childhood malignancies.
🔬Design:Review & Systematic Survey
📍Scope:2015 Verileri
⚙️Variables:Domain Parameters

Özet

Background. Catheter-related bloodstream infection (CRBSI) is one of the most common complications of central lines. Data concerning the effectiveness and safety of antibiotic lock therapy (ALT), especially in pediatric hematology and oncology patients, have not yet reached sufficient levels of evidence. We aimed to share our center’s experience on ALT in pediatric cancer and to investigate the causes of ALT failure. Methods. All cases with CRBSI and treated with ALT administiration in children with cancer between January 2015 and May 2019 were reviewed. Patients characteristics, laboratory and clinical findings, treatments, outcome of ALT, recurrences and reinfections were recorded. Patients with successful and unsuccessful ALT outcomes were compared in order to identify the risk factors for ALT failure. Results. Sixteen eligible CRBSI treated with adjunctive ALT were identified. The most common pathogens were coagulase negative staphylococci (8/16, 50%). Treatment failure was observed in 31.2% (5/16). Younger age alone was an independent risk factor for treatment failure (0.9 vs 6.8 years, p = 0.038). Recurrence and reinfection rates were 23.1% and 16.7%. Mild bleeding occured in two cases (12.5%) and occlusion causing catheter removal was seen in one (6.3%). Conclusions. ALT was found to be a safe modality with a success rate of 68.8% in children with cancer at our center and younger age was an independent risk factor for treatment failure. Future studies with larger sample sizes are needed to determine the factors affecting the ALT outcome, especially in childhood malignancies.

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Cite This Article

ASRAK, H. K., BELET, N., TÜFEKÇİ, Ö., ÖZLÜ, C., BAYSAL, B., İNCE, D. (2021). Investigating the risk factors for antibiotic lock therapy failure in pediatric cancer: a single center retrospective analysis. Turkish Journal of Pediatrics, Cilt: 63 - Sayı: 1, 86–94. https://ajindex.com/articles/399314

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References (13)

  1. Mirro J Jr, Rao BN, Stokes DC, et al. A prospective study of Hickman/Broviac catheters and implantable ports in pediatric oncology patients. J Clin Oncol 1989; 7: 214-222
  2. Wilson MZ, Rafferty C, Deeter D, Comito MA, Hollenbeak CS. Attributable costs of central lineassociated bloodstream infections in a pediatric hematology/oncology population. Am J Infect Control 2014; 42: 1157-1160
  3. Wolf J, Connell TG, Allison KJ, et al. Treatment and secondary prophylaxis with ethanol lock therapy for central line-associated bloodstream infection in paediatric cancer: a randomised, double-blind, controlled trial. Lancet Infect Dis 2018; 18: 854-863
  4. Karagiannidou S, Zaoutis T, Maniadakis N, Papaevangelou V, Kourlaba G. Attributable length of stay and cost for pediatric and neonatal central line-associated bloodstream infections in Greece. J Infect Public Health 2019; 12: 372-379
  5. Mermel LA, Allon M, Bouza E, et al. Clinical practice guidelines for the diagnosis and management of intravascular catheter-related infection: 2009 Update by the Infectious Diseases Society of America. Clin Infect Dis 2009; 49: 1-45
  6. Schoot RA, van Dalen EC, van Ommen CH, van de Wetering MD. Antibiotic and other lock treatments for tunnelled central venous catheterrelated infections in children with cancer. Cochrane Database Syst Rev 2013; 25:CD008975
  7. Norris LB, Kablaoui F, Brilhart MK, Bookstaver PB. Systematic review of antimicrobial lock therapy for prevention of central-line-associated bloodstream infections in adult and pediatric cancer patients. Int J Antimicrob Agents 2017; 50: 308-317
  8. Celebi S, Sezgin ME, Cakır D, et al. Catheterassociated bloodstream infections in pediatric hematology-oncology patients. Pediatr Hematol Oncol 2013; 30: 187-194
  9. Adler A, Yaniv I, Solter E, et al. Catheter-associated bloodstream infections in pediatric hematologyoncology patients: factors associated with catheter removal and recurrence. J Pediatr Hematol Oncol 2006; 28: 23-28
  10. Özdemir H, Karbuz A, Çiftçi E, et al. Successful treatment of central venous catheter infection due to Candida lipolytica by caspofungin-lock therapy. Mycoses 2011; 54: e647-e649
  11. Beck O, Muensterer O, Hofmann S, et al. Central venous access devices (CVAD) in pediatric oncology patients-a single-center retrospective study over more than 9 years. Front Pediatr 2019; 7: 260
  12. Hekimoğlu C, Batır E. Ulusal Sağlık Hizmeti İlişkili Enfeksiyonlar Sürveyans Ağı Özet Raporu 2017. Ankara, 2018
  13. Chaud