Risk Factors and Outcomes of Ambulatory Central-Line Associated Bloodstream Infections in Pediatric Hematology/Oncology Patients
Poster #: 030
Session/Time: A
Author:
Renee Scott Brown, MS
Mentor:
Eric J. Werner, MD M.M.M
Research Type: Review Article
Abstract
INTRODUCTION:
Pediatric hematology/oncology (PHO) patients are at increased risk of central line-associated bloodstream infections (CLABSIs) due to toxic effects of their illness and treatments. While inpatient CLABSIs are a defined hospital quality metric with proven reduction strategies, ambulatory CLABSIs (A-CLABSI) are much less studied than inpatient CLABSI events. The goal of our project is to further identify risk factors and outcomes of A-CLABSI in PHO patients.
METHODS:
A retrospective chart review using contemporaneous huddle forms and electronic medical records, from A-CLABSI events identified in PHO patients in a single institution from 2011-2024 was conducted.
RESULTS:
112 A-CLABSI event huddle forms were located. Data collection has been completed for 44 events. 37 CLABSI infections met the A-CLABSI definition (84%), and 7 were single positive blood cultures (16%). 93% of infections occurred in oncology patients. Patient ages ranged from 12 months to 19 years. All infections resulted in hospitalization, and 11% of patients with A-CLABSIs died within 6 months. 30% of A-CLABSI events resulted in removal of the central line (CL). Of all the A-CLABSIs, 81% had their CL last accessed at the PHO clinic, 16% had their lines last accessed at home and 3% had their lines last accessed at the Emergency Department. 84% were administered IV therapy within 7 days of the event, and 78% of CLABSIs occurred within 6 days of CL access. 24% of CLs with CLABSIs had a prior history of CLABSI. The absolute neutrophil count ranged from 0 to 13,436 with 62% <500 cells/μL at the time of the A-CLABSI.
CONCLUSION:
Preliminary findings show risk factors including cancer diagnosis, neutropenia, line access timing, and prior infection. The fact that 81% of CLs were last accessed in the PHO clinic indicates that this setting may be the most appropriate focus for QI interventions. The hospitalization rate, frequent need for CL removal, and other complications confirm that A-CLABSIs are costly and have significant morbidity. Ongoing analysis of all 112 records is expected to provide further insight to guide potential interventions.
Pediatric hematology/oncology (PHO) patients are at increased risk of central line-associated bloodstream infections (CLABSIs) due to toxic effects of their illness and treatments. While inpatient CLABSIs are a defined hospital quality metric with proven reduction strategies, ambulatory CLABSIs (A-CLABSI) are much less studied than inpatient CLABSI events. The goal of our project is to further identify risk factors and outcomes of A-CLABSI in PHO patients.
METHODS:
A retrospective chart review using contemporaneous huddle forms and electronic medical records, from A-CLABSI events identified in PHO patients in a single institution from 2011-2024 was conducted.
RESULTS:
112 A-CLABSI event huddle forms were located. Data collection has been completed for 44 events. 37 CLABSI infections met the A-CLABSI definition (84%), and 7 were single positive blood cultures (16%). 93% of infections occurred in oncology patients. Patient ages ranged from 12 months to 19 years. All infections resulted in hospitalization, and 11% of patients with A-CLABSIs died within 6 months. 30% of A-CLABSI events resulted in removal of the central line (CL). Of all the A-CLABSIs, 81% had their CL last accessed at the PHO clinic, 16% had their lines last accessed at home and 3% had their lines last accessed at the Emergency Department. 84% were administered IV therapy within 7 days of the event, and 78% of CLABSIs occurred within 6 days of CL access. 24% of CLs with CLABSIs had a prior history of CLABSI. The absolute neutrophil count ranged from 0 to 13,436 with 62% <500 cells/μL at the time of the A-CLABSI.
CONCLUSION:
Preliminary findings show risk factors including cancer diagnosis, neutropenia, line access timing, and prior infection. The fact that 81% of CLs were last accessed in the PHO clinic indicates that this setting may be the most appropriate focus for QI interventions. The hospitalization rate, frequent need for CL removal, and other complications confirm that A-CLABSIs are costly and have significant morbidity. Ongoing analysis of all 112 records is expected to provide further insight to guide potential interventions.