title: Central line-associated bloodstream infection in childhood malignancy: Single-center experience.
abstract: BACKGROUND
  Central line-associated bloodstream infection (CLABSI) is a common complication in children with malignancy, often leading to prolonged hospitalization, delay in chemotherapy or catheter removal. This retrospective epidemiological study reviewed 91 children with malignancy over a 5 year period between 2011 and 2015 and analyzed potential risk factors for CLABSI.
  
  
  METHODS
  Symptoms, laboratory and microbiology characteristics, subsequent treatment and outcome were recorded and analyzed. All the collected data were processed through SPSS for statistical analysis.
  
  
  RESULTS
  Among 40 episodes of CLABSI recorded in 30 patients, the rate of CLABSI was estimated as 2.62 episodes per 1,000 days of central venous catheter (CVC) carriage. Most of the bacterial pathogens isolated in CLABSI episodes were Gram positive, including different strains of staphylococci, while Gram-negative bacteria were involved in 30% of episodes. Invasive mycosis was isolated in 7.5% of episodes, accounting for the highest catheter removal rate. Intensive chemotherapy and prolonged hospitalization proved to be independent risk factors for CVC infection. In children with neutropenia, the risk for CLABSI was also fourfold greater (P = 0.001). Children with leukemia had a fivefold greater risk for CLABSI (P = 0.005). Finally, although 36% of patients received antibiotic lock therapy, in 15% of these patients catheter replacement could not be avoided due to persistent serious infection.
  
  
  CONCLUSIONS
  Younger age, neutropenia, hematologic malignancy and longer catheterization are important risk factors for CLABSI, but further research is required for the prevention of catheter-related infection in children with malignancy.
authors.affiliation: Department of Pediatric Hematology-Oncology, University Hospital of Heraklion, University of Crete, Heraklion, Greece.
authors.forename: Marianna
authors.initials: M
authors.lastname: Miliaraki
authors.affiliation: Department of Pediatric Hematology-Oncology, University Hospital of Heraklion, University of Crete, Heraklion, Greece.
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Katzilakis
authors.affiliation: Department of Pediatric Hematology-Oncology, University Hospital of Heraklion, University of Crete, Heraklion, Greece.
authors.forename: Ioanna
authors.initials: I
authors.lastname: Chranioti
authors.affiliation: Department of Pediatric Hematology-Oncology, University Hospital of Heraklion, University of Crete, Heraklion, Greece.
authors.forename: Maria
authors.initials: M
authors.lastname: Stratigaki
authors.affiliation: Department of Pediatric Hematology-Oncology, University Hospital of Heraklion, University of Crete, Heraklion, Greece.
authors.forename: Maria
authors.initials: M
authors.lastname: Koutsaki
authors.affiliation: Department of Pediatric Hematology-Oncology, University Hospital of Heraklion, University of Crete, Heraklion, Greece.
authors.forename: Maria
authors.initials: M
authors.lastname: Psarrou
authors.affiliation: Department of Pediatric Hematology-Oncology, University Hospital of Heraklion, University of Crete, Heraklion, Greece.
authors.forename: Emmanouil
authors.initials: E
authors.lastname: Athanasopoulos
authors.affiliation: Department of Pediatric Hematology-Oncology, University Hospital of Heraklion, University of Crete, Heraklion, Greece.
authors.forename: Eftichia
authors.identifier: http://orcid.org/0000-0002-3343-5110
authors.initials: E
authors.lastname: Stiakaki
mesh_terms: D000293:Adolescent; D016470:Bacteremia / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D055499:Catheter-Related Infections / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D005260:Female; D016905:Gram-Negative Bacterial Infections / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D016908:Gram-Positive Bacterial Infections / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009369:Neoplasms / Q000628:therapy*; D012189:Retrospective Studies; D012307:Risk Factors
keywords: catheter-related infection; central venous catheter; child; hematologic neoplasm; leukemia