title: Central Venous Catheters and Bloodstream Infection During Induction Therapy in Children With Acute Lymphoblastic Leukemia.
abstract: The purpose of the study was to assess the risk of first-time bloodstream infection (BSI) according to type of central venous catheter (CVC) during induction therapy in children with acute lymphoblastic leukemia (ALL). Patients eligible for our analysis were all newly diagnosed children with ALL treated at 3 pediatric centers in Denmark between 2008 and 2014. A total of 136 patients were followed from initial CVC placement until first BSI, CVC removal, death, or day 28, whichever occurred first. Thirty-nine BSIs were detected, of which 67% were gram-positive infections, and 59% met the criteria for being CVC associated. The 28-day cumulative incidence of BSI was similar in 77 patients with a nontunneled CVC (28%; 95% confidence interval, 19%-40%) and in 59 patients with a tunneled CVC with external lines (TE) (33%; 95% confidence interval, 23%-47%). Subgroup analyses showed that gram-negative blood isolates occurred more frequently in patients with a TE, and that lower incidences of BSI were detected in patients older than 9 years with a TE, and in patients with T-ALL. It is concluded that the type of CVC inserted at diagnosis has no impact upon the risk of BSI in patients with ALL undergoing induction therapy.
authors.affiliation: *Department of Pediatrics, Aarhus University Hospital, Aarhus †Department of Pediatrics, Odense University Hospital, Odense ‡Department of Pediatrics, Aalborg University Hospital, Aalborg, Denmark.
authors.forename: Kristin
authors.initials: K
authors.lastname: Bergmann
authors.forename: Henrik
authors.initials: H
authors.lastname: Hasle
authors.forename: Peter
authors.initials: P
authors.lastname: Asdahl
authors.forename: Mette M
authors.initials: MM
authors.lastname: Handrup
authors.forename: Peder S
authors.initials: PS
authors.lastname: Wehner
authors.forename: Steen
authors.initials: S
authors.lastname: Rosthøj
authors.forename: Henrik
authors.initials: H
authors.lastname: Schrøder
mesh_terms: D055499:Catheter-Related Infections / Q000453:epidemiology* / Q000209:etiology; D002405:Catheterization, Central Venous / Q000009:adverse effects / Q000295:instrumentation; D062905:Central Venous Catheters / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003718:Denmark / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D060828:Induction Chemotherapy; D007223:Infant; D008297:Male; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy*; D018805:Sepsis / Q000453:epidemiology* / Q000209:etiology*