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The applicability of the central line-associated bloodstream infection (CLABSI) criteria for the evaluation of bacteremia episodes in pediatric oncology patients.
van den Bosch, Ceder H; Frakking, Florine N J; Loeffen, Yvette G T; van Tinteren, Harm; van der Steeg, Alida F W; Wijnen, Marc H W A; van de Wetering, Marianne D; van der Bruggen, Jan-Tom.
Afiliación
  • van den Bosch CH; Princess Máxima Centre for Pediatric Oncology, Utrecht, The Netherlands.
  • Frakking FNJ; Department of Medical Microbiology, University Medical Centre Utrecht, Utrecht, The Netherlands.
  • Loeffen YGT; Department of Pediatric Infectious Diseases and Immunology, Wilhelmina Children's Hospital, Utrecht, The Netherlands.
  • van Tinteren H; Princess Máxima Centre for Pediatric Oncology, Utrecht, The Netherlands.
  • van der Steeg AFW; Princess Máxima Centre for Pediatric Oncology, Utrecht, The Netherlands.
  • Wijnen MHWA; Princess Máxima Centre for Pediatric Oncology, Utrecht, The Netherlands.
  • van de Wetering MD; Princess Máxima Centre for Pediatric Oncology, Utrecht, The Netherlands.
  • van der Bruggen JT; Department of Medical Microbiology, University Medical Centre Utrecht, Utrecht, The Netherlands.
Eur J Haematol ; 112(5): 832-839, 2024 May.
Article en En | MEDLINE | ID: mdl-38294085
ABSTRACT

BACKGROUND:

The aim of this study was to investigate the applicability of the central line-associated bloodstream infection (CLABSI) criteria of the Centers for Disease Control and Prevention in pediatric oncology patients.

METHODS:

Bacteremia episodes from 2020 to 2022 from a prospective cohort of pediatric oncology patients with a central venous catheter were included. Episodes were classified by three medical experts following the CLABSI criteria as either a CLABSI or non-CLABSI (i.e., contamination, other infection source, or mucosal barrier injury-laboratory confirmed bloodstream infection (MBI-LCBI)). Subsequently, they were asked if and why they (dis)agreed with this diagnosis following the criteria. The primary outcome was the percentage of episodes where the experts clinically disagreed with the diagnosis given following the CLABSI criteria.

RESULTS:

Overall, 84 bacteremia episodes in 71 patients were evaluated. Following the CLABSI criteria, 34 (40%) episodes were classified as CLABSIs and 50 (60%) as non-CLABSIs. In 11 (13%) cases the experts clinically disagreed with the diagnosis following the CLABSI criteria. The discrepancy between the CLABSI criteria and clinical diagnosis was significant; McNemar's test p < .01. Disagreement by the experts with the CLABSI criteria mostly occurred when the experts found an MBI-LCBI a more plausible cause of the bacteremia than a CLABSI due to the presence of a gram negative bacteremia (Pseudomonas aeruginosa n = 3) and/or mucositis.

CONCLUSIONS:

A discrepancy between the CLABSI criteria and the evaluation of the experts was observed. Adding Pseudomonas aeruginosa as an MBI pathogen and incorporating the presence of mucositis in the MBI-LCBI criteria, might increase the applicability.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Cateterismo Venoso Central / Bacteriemia / Sepsis / Mucositis / Infecciones Relacionadas con Catéteres / Neoplasias Tipo de estudio: Risk_factors_studies Límite: Child / Humans Idioma: En Revista: Eur J Haematol Asunto de la revista: HEMATOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Países Bajos Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Cateterismo Venoso Central / Bacteriemia / Sepsis / Mucositis / Infecciones Relacionadas con Catéteres / Neoplasias Tipo de estudio: Risk_factors_studies Límite: Child / Humans Idioma: En Revista: Eur J Haematol Asunto de la revista: HEMATOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Países Bajos Pais de publicación: Reino Unido