Journal article
Risk of bacterial bloodstream infection does not vary by central-line type during neutropenic periods in pediatric acute myeloid leukemia
INFECTION CONTROL AND HOSPITAL EPIDEMIOLOGY, v 44(2), p222
Feb 2023
PMID: 35465865
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Background: Bloodstream infections (BSIs) are a frequent cause of morbidity in patients with acute myeloid leukemia (AML), due in part to the presence of central venous access devices (CVADs) required to deliver therapy. Objective: To determine the differential risk of bacterial BSI during neutropenia by CVAD type in pediatric patients with AML. Methods: We performed a secondary analysis in a cohort of 560 pediatric patients (1,828 chemotherapy courses) receiving frontline AML chemotherapy at 17 US centers. The exposure was CVAD type at course start: tunneled externalized catheter (TEC), peripherally inserted central catheter (PICC), or totally implanted catheter (TIC). The primary outcome was course-specific incident bacterial BSI; secondary outcomes included mucosal barrier injury (MBI)-BSI and non-MBI BSI. Poisson regression was used to compute adjusted rate ratios comparing BSI occurrence during neutropenia by line type, controlling for demographic, clinical, and hospital-level characteristics. Results: The rate of BSI did not differ by CVAD type: 11 BSIs per 1,000 neutropenic days for TECs, 13.7 for PICCs, and 10.7 for TICs. After adjustment, there was no statistically significant association between CVAD type and BSI: PICC incident rate ratio [IRR] = 1.00 (95% confidence interval [CI], 0.75-1.32) and TIC IRR = 0.83 (95% CI, 0.49-1.41) compared to TEC. When MBI and non-MBI were examined separately, results were similar. Conclusions: In this large, multicenter cohort of pediatric AML patients, we found no difference in the rate of BSI during neutropenia by CVAD type. This may be due to a risk-profile for BSI that is unique to AML patients.
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Details
- Title
- Risk of bacterial bloodstream infection does not vary by central-line type during neutropenic periods in pediatric acute myeloid leukemia
- Publication Details
- INFECTION CONTROL AND HOSPITAL EPIDEMIOLOGY, v 44(2), p222
- Publisher
- CAMBRIDGE UNIV PRESS; NEW YORK
- Grant note
- This research was supported by the Patient Centered Outcomes Research Institute (grant no. CER-1409-22827). Dr. William Otto's effort on his project was supported in part by a NICHD Training Award (grant no. T32 HD043021). Dr. Kelly Getz's effort on this project was supported in part by a NHLBI Career Development Award (grant no. 1K01HL143153). The content of this publication does not necessarily reflect the views of policies of the Department of Health and Human Services, nor does mention of trade names, commercial products, or organizations imply endorsement by the US government.
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Drexel University
- Web of Science ID
- WOS:000786380400001
- Scopus ID
- 2-s2.0-85129691406
- Other Identifier
- 991021861189104721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Infectious Diseases
- Public, Environmental & Occupational Health