ANTIBIOTIC LOCK THERAPY FOR PORT CATHETER-RELATED INFECTIONS OF CHILDREN WITH ACUTE LEUKEMIA
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Keywords
Acute leukemia,, central venous catheter, Antibiotic Lock therapy, Infection
Abstract
Background: Port catheters facilitate the administration of chemotherapy, antibiotics, blood products, fluid and parenteral nutritional support to pediatric patients with hematological malignancies. However, as its use has become widespread, local, and systemic catheter-related infections have emerged as important causes of morbidity and mortality. In our study, we aimed to evaluate the success of antibiotic lock therapy in port catheter- related infections of pediatric patients followed up with acute leukemia.
Methods: Port catheter cultures taken from a total of 182 pediatric patients with acute lymphoblastic/myeloblastic leukemia who were followed up at Ankara City Hospital Pediatric Hematology Clinic between August 2019 and August 2023 were evaluated retrospectively. Results: Bacterial growth was identified in 739 port catheter culture specimens of 182 patients. Closure or removal of the port was required in 91, and removal of the port catheters in 49 patients due to port catheter-related infections. Antibiotic lock therapy was started in 56 patients with bacterial growth in the port catheter. With antibiotic lock therapy, port catheter-related infections of 42 patients were eradicated, and their catheters began to be used again. As a result, the port catheter-related infections of 42 of 56 (75%) patients whose ports were closed and also received systemic antibiotherapy were eradicated, and no recurrence of infection was observed.
Conclusion: Adding antibiotic lock therapy to systemic antibiotics in pediatric patients may be beneficial in terms of catheter salvage.
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References
1. Wolf J, Allison KJ, Tang L, Sun Y, Hayden RT, Flynn PM: No evidence of benefit from antibiotic lock therapy in pediatric oncology patients with central line-related bloodstream infection: results of a retrospective matched cohort study and review of the literature. Pediatric blood & cancer 2014, 61(10):1811-1815.
2. Adler A, Yaniv I, Solter E, Freud E, Samra Z, Stein J, Fisher S, Levy I: Catheter-associated bloodstream infections in pediatric hematology-oncology patients: factors associated with catheter removal and recurrence. Journal of pediatric hematology/oncology 2006, 28(1):23-28.
3. Sievert DM, Ricks P, Edwards JR, Schneider A, Patel J, Srinivasan A, Kallen A, Limbago B, Fridkin S: Antimicrobial-resistant pathogens associated with healthcare-associated infections: summary of data reported to the National Healthcare Safety Network at the Centers for Disease Control and Prevention, 2009-2010. Infection control and hospital epidemiology 2013, 34(1):1-14.
4. Flynn PM: Diagnosis and management of central venous catheter-related bloodstream infections in pediatric patients. The Pediatric infectious disease journal 2009, 28(11):1016-1017.
5. Yacobovich J, Ben-Ami T, Abdalla T, Tamary H, Goldstein G, Weintraub M, Yaniv I, Toren A, Kenet G, Revel-Vilk S: Patient and central venous catheter related risk factors for blood stream infections in children receiving chemotherapy. Pediatric blood & cancer 2015, 62(3):471-476.
6. Ceri H, Olson ME, Stremick C, Read RR, Morck D, Buret A: The Calgary Biofilm Device: new technology for rapid determination of antibiotic susceptibilities of bacterial biofilms. Journal of clinical microbiology 1999, 37(6):1771-1776.
7. De Sio L, Jenkner A, Milano GM, Ilari I, Fidani P, Castellano A, Gareri R, Donfrancesco A: Antibiotic lock with vancomycin and urokinase can successfully treat colonized central venous catheters in pediatric cancer patients. The Pediatric infectious disease journal 2004, 23(10):963-965.
8. Mermel LA, Allon M, Bouza E, Craven DE, Flynn P, O'Grady NP, Raad, II, Rijnders BJ, Sherertz RJ, Warren DK: Clinical practice guidelines for the diagnosis and management of intravascular catheter-related infection: 2009 Update by the Infectious Diseases Society of America. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America 2009, 49(1):1-45.
9. Tsai HC, Huang LM, Chang LY, Lee PI, Chen JM, Shao PL, Hsueh PR, Sheng WH, Chang YC, Lu CY: Central venous catheter-associated bloodstream infections in pediatric hematology-oncology patients and effectiveness of antimicrobial lock therapy. Journal of microbiology, immunology, and infection = Wei mian yu gan ran za zhi 2015, 48(6):639-646.
10. Justo JA, Bookstaver PB: Antibiotic lock therapy: review of technique and logistical challenges. Infection and drug resistance 2014, 7:343-363.
11. Castagnola E, Ginocchio F: Rescue therapy of difficult-to-treat indwelling central venous catheter-related bacteremias in cancer patients: a review for practical purposes. Expert review of anti-infective therapy 2013, 11(2):179-186.
12. Ford WJH, Bundy DG, Oyeku S, Heo M, Saiman L, Rosenberg RE, DeLaMora P, Rabin B, Zachariah P, Mirhaji P et al: Central Venous Catheter Salvage in Ambulatory Central Line-Associated Bloodstream Infections. Pediatrics 2021, 148(6).
13. Buonsenso D, Salerno G, Sodero G, Mariani F, Pisapia L, Gelormini C, Di Nardo M, Valentini P, Scoppettuolo G, Biasucci DG: Catheter salvage strategies in children with central venous catheter-related or -associated bloodstream infections: a systematic review and meta-analysis. The Journal of hospital infection 2022, 125:1-20.
14. Celebi S, Sezgin ME, Cakır D, Baytan B, Demirkaya M, Sevinir B, Bozdemir SE, Gunes AM, Hacimustafaoglu M: Catheter-associated bloodstream infections in pediatric hematology-oncology patients. Pediatr Hematol Oncol 2013, 30(3):187-194.
15. O'Horo JC, Silva GL, Safdar N: Anti-infective locks for treatment of central line-associated bloodstream infection: a systematic review and meta-analysis. American journal of nephrology 2011, 34(5):415-422.
16. Kara TT, Özdemir H, Erat T, Yahşi A, Aysev AD, Taçyıldız N, Ünal E, İleri T, İnce E, Haskoloğlu Ş et al: Is antibiotic lock therapy effective for the implantable longterm catheter-related bloodstream infections in children? The Turkish journal of pediatrics 2019, 61(6):895-904.
17. Tural Kara T, Erat T, Yahşi A, Özdemir H, İleri T, İnce E, Taçyıldız N, Ünal E, Çiftçi E, İnce E: Bloodstream infections in pediatric hematology/oncology patients: Six years’ experience of a single center in Turkey. Turkish journal of medical sciences 2019, 49(4):1157-1164.
18. Signorino C, Fusco E, Galli L, Chiappini E: Effectiveness of Antimicrobial Lock Therapy for the Treatment of Catheter-Related and Central-Line-Associated Bloodstream Infections in Children: A Single Center Retrospective Study. Antibiotics (Basel, Switzerland) 2023, 12(5).
19. Eggimann P, Pittet D: Overview of catheter-related infections with special emphasis on prevention based on educational programs. Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases 2002, 8(5):295-309.
20. van de Wetering MD, Poole J, Friedland I, Caron HN: Bacteraemia in a paediatric oncology unit in South Africa. Medical and pediatric oncology 2001, 37(6):525-531.
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