1. Peripheral Venous Catheter-related Bloodstream Infections in Hospitalized Children: The Role of Gram-negative Bacteria.
- Author
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Berger I, Cohen T, Rahmani E, Levy I, Lowenthal A, Levinsky Y, Goldberg L, Marcus N, Kropach N, Ben-Zvi H, Chodik G, Ashkenazi-Hoffnung L, and Scheuerman O
- Subjects
- Adolescent, Catheter-Related Infections epidemiology, Child, Child, Preschool, Cross Infection microbiology, Female, Gram-Negative Bacteria classification, Gram-Negative Bacteria isolation & purification, Gram-Negative Bacterial Infections etiology, Gram-Positive Bacteria classification, Gram-Positive Bacteria isolation & purification, Humans, Infant, Male, Retrospective Studies, Sepsis microbiology, Tertiary Care Centers statistics & numerical data, Catheter-Related Infections microbiology, Central Venous Catheters adverse effects, Gram-Negative Bacteria pathogenicity, Gram-Negative Bacterial Infections epidemiology, Hospitalization statistics & numerical data, Sepsis epidemiology, Sepsis etiology
- Abstract
Background: Peripheral venous catheter (PVC) is the most used vascular access device in medicine, allowing administration of intravenous fluids and medications. Known complications associated with PVC include extravasation, phlebitis and rarely bloodstream infection (BSI). Data regarding PVC-related BSI in children are lacking. Our aim was to evaluate the epidemiology, clinical and microbiologic characteristics of pediatric inpatients with PVC-related BSI., Methods: A retrospective study was conducted in a pediatric tertiary care center. Children with BSI, admitted to general pediatric departments during 2010-2019, were identified and their medical records examined. Patients with BSI and phlebitis were further characterized and included in the analysis. We excluded patients with central venous catheters, other identified source of infection and with BSI upon admission. Data collected included patients' demographics and clinical and microbiologic characteristics., Results: Twenty-seven children with PVC-related BSI were identified and included in the study, consisting of 0.2% of the total BSI cases. Patient's median age was 24 (range, 1.5-213) months, 14/27 (52%) were female and 6 (22%) were previously healthy while 21 (78%) had prior medical conditions. Sixteen (59.3%) patients had Gram-negative BSI and 6 (22.2%) Gram-positive bacteria. Polymicrobial infection occurred in 4 (14.8%) patients and Candida albicans in 1 (3.7%) patient. The most common isolated bacteria were Klebsiella spp and Staphylococcus aureus. Longer dwell-time was a predictor of Gram-negative bacteria., Conclusions: PVC-related BSI due to Gram-negative bacteria was more common than to Gram-positive bacteria. Clinicians should consider an initial broad-spectrum antibiotic coverage for PVC-related BSI in hospitalized pediatric patients., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)
- Published
- 2021
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