The evaluation of Candida-related central line-related bloodstream infections in pediatric cancer patients: A pre- and post-intervention study

Abstract

Aim/Objections

The purpose of this study was to assess the efficacy of a central line maintenance bundle in preventing catheter-related (implanted venous access devices, port) Candida bloodstream infections.

Methods

The study encompassed two distinct time periods, namely, pre-bundle and bundle. The number of catheter-related bloodstream infections (CRBSI) episodes per catheter days for each timeframe was determined.

Findings/Results

Upon implementation of the central line bundle, the rate of CRBSI reduced significantly from 4.27 per 1000 central line days in the pre-bundle period to 1.0 per 1000 central line days in the bundle period (p < .001).

Discussion

Using a central line bundle to avoid CRBSIs in pediatric cancer patients with ports led to a significant decrease in Candida species-related CRBSIs.

Keywords

Candida port catheter-related bloodstream infections bundle

Get full access to this article

View all access options for this article.

References

Akbari

Kjellerup

(2015) Elimination of bloodstream infections associated with Candida albicans biofilm in intravascular catheters. Pathogens 4(3): 457–469. DOI: 10.3390/pathogens4030457.

Barrell

Covington

Bhatia

, et al. (2012) Preventive strategies for central line-associated bloodstream infections in pediatric hematopoietic stem cell transplant recipients. American Journal of Infection Control 40(5): 434–439. DOI: 10.1016/j.ajic.2011.06.002.

Devrim

Oruc

Demirag

, et al. (2018) Central line bundle for prevention of central line–associated bloodstream infection for totally implantable venous access devices (ports) in pediatric cancer patients. The Journal of Vascular Access 19(4): 358–365. DOI: 10.1177/1129729818757955.

Devrim

Ozkul

Caglar

, et al. (2020) Central line bundle including split-septum device and single-use prefilled flushing syringes to prevent port-associated bloodstream infections: a cost and resource-utilization analysis. BMC Health Services Research 20(1):336. DOI: 10.1186/s12913-020-05221-6.

Douglas

(2003) Candida biofilms and their role in infection. Trends in Microbiology 11: 30–36. DOI: 10.1016/s0966-842x(02)00002-1.

Gorski

Hadaway

Hagle

, et al. (2021) Infusion therapy standards of practice updates. J Infus Nurs 44(4):189–190. doi: 10.1097/NAN.0000000000000436.

Gowin

Świątek-Kościelna

Mańkowski

, et al. (2020) The profile of microorganisms responsible for port-related bacteremia in pediatric hemato-oncological patients. Cancer Control 27(1): 1073274820904696. DOI: 10.1177/1073274820904696.

Mantadakis

Pana

Zaoutis

(2018) Candidemia in children: epidemiology, prevention and management. Mycoses 61: 614–622. DOI: 10.1111/myc.12792.

Mermel

Allon

Bouza

, et al. (2009) 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 49: 1–45. DOI: 10.1086/599376.

10.

O'Grady

Alexander

Burns

, et al. (2011) Healthcare infection control practices advisory committee (HICPAC) (appendix 1). Summary of recommendations: guidelines for the prevention of intravascular catheter-related infections. Clinical Infectious Diseases52(9):1087–1099. DOI: 10.1093/cid/cir138.

11.

Rinke

Chen

Bundy

, et al. (2012) Implementation of a central line maintenance care bundle in hospitalized pediatric oncology patients. Pediatrics 130(4):e996–e1004.

12.

Trofa

Gácser

Nosanchuk

(2008) Candida parapsilosis, an emerging fungal pathogen. Clinical Microbiology Reviews 21: 606–625. DOI: 10.1128/CMR.00013-08.

13.

Vasileiou

Paisiou

Tsipou

, et al. (2020) Candidemia in children with malignancies: report from the infection working group of the hellenic society of pediatric hematology-oncology. J Fungi (Basel) 6(4):276. DOI: 10.3390/jof6040276.