Catheter-related bloodstream infections (CRBSIs) in pediatric patients with cancers were not associated with low preoperative absolute neutrophil counts (ANCs) or preoperative antibiotic treatment. These findings from a retrospective review of patient records were published in The Pediatric Infectious Disease Journal.
As the relationship between CRBSIs and perioperative neutropenia or antibiotic prophylaxis is not well understood, researchers retrospectively reviewed records from their tertiary pediatric hospital. They assessed 243 patients who had a central venous access device (CVAD) inserted between 2009 and 2015 for risk factors for CRBSIs.
Patients had hematologic malignancies (72.0%) or solid tumors (28.0%).
CRBSIs were detected in 17 patients at a median 14 days (range, 8 to 28) after implantation. They occurred more often with hematologic malignancies than solid tumors (76.5% and 23.5%, respectively).
Culprit organisms included Enterococcus aerogenes, Escherichia coli, Acinetobacter Baumannii, Chryseobacterium indologenes, Staphylococcus aureus, Streptococcus viridans, micrococcus species, and Bacillus species.
The only risk factor associated with CRBSIs was acute myeloid leukemia (AML) or other leukemias (odds ratio [OR], 5.09; 95% CI, 1.27-20.30; P =.0036) compared with solid tumors or lymphoma.
Neither use of perioperative antibiotics (OR, 1.25; 95% CI, 0.42-3.74; P =.6862) nor low absolute neutrophil count (OR, 1.10; 95% CI, 0.35-3.49; P =.8216) associated with CRBSI risk.
Evidence suggested that postoperative neutropenia may be associated with CRBSIs, as patients with AML or other leukemias who had early CRBSI continued to have protracted neutropenia after device insertion.
This study may have been limited as the use of preoperative antibiotics was not controlled and varied among patients.
The study authors concluded that these findings did not support the use of antibiotics prior to insertion of a central venous access device to prevent CRBSIs in pediatric patients with cancers.
Cher WQ, Lee V, Wang R, et al. Postoperative rather than preoperative neutropenia is associated with early catheter-related bloodstream infections in newly diagnosed pediatric cancer patients. Pediatr Infect Dis J. Published online September 28, 2021. doi:10.1097/INF.0000000000003315