Surveillance of bloodstream infections in pediatric cancer centers - what have we learned and how do we move on?
Pediatric patients receiving conventional chemotherapy for malignant disease face an increased risk of bloodstream infection (BSI). Since BSI may represent an acute life-threatening event in patients with profound immunosuppression, and show further negative impact on quality of life and anticancer treatment, the prevention of BSI is of paramount importance to improve and guarantee patients' safety during intensive treatment. The great majority of all pediatric cancer patients (about 85%) have a long-term central venous access catheter in use (type Broviac or Port; CVAD). Referring to the current surveillance definitions a significant proportion of all BSI in pediatric patients with febrile neutropenia is categorized as CVAD-associated BSI. This state of the art review summarizes the epidemiology and the distinct pathogen profile of BSI in pediatric cancer patients from the perspective of infection surveillance. Problems in executing the current surveillance definition in this patient population are discussed and a new concept for the surveillance of BSI in pediatric cancer patients is outlined.
Pädiatrische Onkologie und Hämatologie, Universitätsklinikum des Saarlandes, Homburg, Germany.
Arne
A
Simon
Pädiatrische Onkologie und Hämatologie, Universitätsklinikum des Saarlandes, Homburg, Germany.
Rhoikos
R
Furtwängler
Pädiatrische Onkologie und Hämatologie, Universitätsklinikum des Saarlandes, Homburg, Germany.
Norbert
N
Graf
Klinik für Pädiatrische Onkologie, Hämatologie und Immunologie, Universitätskinderklinik, Heinrich-Heine-Universität, Düsseldorf, Germany.
Hans Jürgen
HJ
Laws
Klinik für Pädiatrie m. S. Onkologie / Hämatologie / Stammzelltransplantation, Charité - Universitätsmedizin Berlin, Germany.
Sebastian
S
Voigt
Institut für Hygiene und Umweltmedizin, Charité - Universitätsmedizin Berlin, Germany.
Brar
B
Piening
Institut für Hygiene und Umweltmedizin, Charité - Universitätsmedizin Berlin, Germany.
Christine
C
Geffers
Pädiatrische Infektiologie und Pädiatrische Hämatologie-Onkologie, Universitätsklinik für Kinderheilkunde, Inselspital, Bern, Switzerland.
Philipp
P
Agyeman
Pädiatrische Infektiologie und Pädiatrische Hämatologie-Onkologie, Universitätsklinik für Kinderheilkunde, Inselspital, Bern, Switzerland.
Roland A
RA
Ammann
Broviac; Port; bloodstream infection; pediatric oncology; surveillance