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Central-line–associated bloodstream infections in a pediatric oncology and hematology hospital at home program

Published online by Cambridge University Press:  01 August 2022

Sylvain C. Raimbault Open the ORCID record for Sylvain C. Raimbault [Opens in a new window] ,
Carine Domenech Open the ORCID record for Carine Domenech [Opens in a new window] ,
Christine Fuhrmann  and
Amandine Bertrand Open the ORCID record for Amandine Bertrand [Opens in a new window]
Sylvain C. Raimbault*
Affiliation:
Institute of Pediatric Hematology and Oncology (IHOPe), Lyon, France
Carine Domenech
Affiliation:
Institute of Pediatric Hematology and Oncology (IHOPe), Lyon, France Faculté de médecine et de maïeutique Lyon Sud, Université Claude Bernard Lyon 1, Hospices Civils de Lyon, Lyon, France Apoptosis, Cancer and Development Laboratory, Cancer Research of Center of Lyon, INSERM U1052-CNRS UMR5286, Lyon, France
Christine Fuhrmann
Affiliation:
Institut des agents infectieux et de pathologies infectieuses, Hospices Civils de Lyon, Lyon, France Centre Léon Bérard, Lyon, France
Amandine Bertrand
Affiliation:
Institute of Pediatric Hematology and Oncology (IHOPe), Lyon, France U1290, Research on Healthcare Performance (RESHAPE), Lyon, France
*
Author for correspondence: Sylvain C. Raimbault, E-mail: sylvain.raimbault@chu-lyon.fr
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Abstract

Objective:

Central-line–associated bloodstream infections (CLABSIs) are associated with significant morbidity among pediatric oncology-hematology patients, and risk factors remain largely unknown in the setting of hospital at home (HAH). Children in HAH receive intensive treatment (eg, chemotherapy and parenteral nutrition), with frequent central-line handling; thus, they may be at higher risk for CLABSI.

Methods:

We conducted a monocentric retrospective study of patients with a central line included in our HAH program from January 1 to December 31, 2016. HAH patient characteristics for children developing CLABSIs were compared to those who did not, based on blood cultures positive for infection and clinical data of all patients included.

Results:

Overall, 492 HAH stays were analyzed, with 144 patients. The overall CLABSI rate in these patients was 2.6 per 1,000 central-line days. Children who developed CLABSIs were younger (median age, 2.5 vs 8.8 years; P < .001), suffered more from hematological pathologies (malignant or nonmalignant, 75% vs 52%; P = .02), and had more frequently undergone hematopoietic stem-cell transplantation (30.8% vs 6.5%; P = .01). In addition, these patients often had a tunneled externalized catheter as the central line and were more frequently given parenteral nutrition at home (46% vs 8%; P < .001).

Conclusions:

CLABSI rates for children in HAH were more similar to those of inpatients than to rates previously reported for ambulatory patients. The factors associated with infection identified herein should be further validated in multicentric studies and considered to improve HAH practices, parallel to prevention measures used in the inpatient setting.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 44 , Issue 5 , May 2023 , pp. 780 - 785
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Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America

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