title: Bench-to-bedside review: Challenges of diagnosis, care and prevention of central catheter-related bloodstream infections in children.
abstract: Central venous catheters (CVCs) are indispensable in modern pediatric medicine. CVCs provide secure vascular access, but are associated with a risk of severe complications, in particular bloodstream infection. We provide a review of the recent literature about the diagnostic and therapeutic challenges of catheter-related bloodstream infection (CRBSI) in children and its prevention. Variations in blood sampling and limitations in blood culturing interfere with accurate and timely diagnosis of CRBSI. Although novel molecular testing methods appear promising in overcoming some of the present diagnostic limitations of conventional blood sampling in children, they still need to solidly prove their accuracy and reliability in clinical practice. Standardized practices of catheter insertion and care remain the cornerstone of CRBSI prevention although their implementation in daily practice may be difficult. Technology such as CVC impregnation or catheter locking with antimicrobial substances has been shown less effective than anticipated. Despite encouraging results in CRBSI prevention among adults, the goal of zero infection in children is still not in range. More high-quality research is needed in the field of prevention, accurate and reliable diagnostic measures and effective treatment of CRBSI in children.
authors.forename: Susanne
authors.initials: S
authors.lastname: Janum
authors.forename: Walter
authors.initials: W
authors.lastname: Zingg
authors.forename: Volker
authors.initials: V
authors.lastname: Classen
authors.forename: Arash
authors.initials: A
authors.lastname: Afshari
mesh_terms: D000890:Anti-Infective Agents / Q000008:administration & dosage; D055499:Catheter-Related Infections / Q000175:diagnosis* / Q000517:prevention & control* / Q000628:therapy; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D002408:Catheters, Indwelling / Q000382:microbiology; D002648:Child; D003428:Cross Infection / Q000175:diagnosis* / Q000517:prevention & control* / Q000628:therapy; D006801:Humans
chemical_list: D000890:Anti-Infective Agents
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