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CLABSIs more prevalent in cancer patients treated at home
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Children with cancer using central lines at home to treat them develop central line-associated bloodstream infections three times more than hospitalized children with central lines, according to recent study findings published in Pediatric Blood & Cancer.
“Some children with central lines do well at home and will have no complications, but based on our findings, we feel clinicians should remain vigilant when sending home certain special categories of pediatric cancer patients who face higher infection risk by virtue of their condition, device type or a combination of the two,” Michael L. Rinke, MD, PhD, pediatrician and safety experts at Johns Hopkins Children’s Center, said in a press release.
The prospective study included 319 children with cancer using central lines treated between 2009 and 2010.
Researchers found that there were 19 central line-associated bloodstream infections (CLABSIs) during 8,682 days in hospitalized participants with a central line compared with 55 CLABSIs during 84,705 days in the at-home participants.
“We have a wealth of data on the safety of central lines among hospitalized children and have designed solid protocols to reduce the risk of invasive bloodstream infections among such children, but we don’t really have a good understanding of central line safety once the child leaves the hospital,” Marlene Miller, MD, MSc, director of pediatric quality and safety at Johns Hopkins Children’s Center, said in a press release. “Our study sheds some light on that issue.”
Thirty-one percent of the at-home participants were neutropenic at CLABSI diagnosis and 19% were within 100 days of a bone marrow transplant. After diagnosis, 13% of participants were admitted to the ICU within 72 hours of admission, 44% had lines removed and one participant died during CLABSI hospitalization.
“Ambulatory CLABSIs extract a greater absolute toll in morbidity and mortality than inpatient CLABSIs and we need to start focusing our CLABSI reduction efforts on ambulatory patients as well,” Rinke told Infectious Diseases in Children.
Disclosure: Rinke reports financial relationships with the Agency for Healthcare Research and Quality and NIH. Some researchers also report financial relationships with the Children’s Hospital Association.
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