Instituting a New Central Line Policy to Decrease Central Line-associated Blood Stream Infection Rates during Induction Therapy in Pediatric Acute Lymphoblastic Leukemia Patients

Rebecca Berger, Allison F. Messina, Nicole M. Chandler, Ernest K. Amankwah, Peter H. Shaw

Research output: Contribution to journalArticlepeer-review

Abstract

Background:Children with acute lymphoblastic leukemia (ALL) require central lines to facilitate their care. Peripherally inserted central catheters (PICCs) may have lower rates of central line-associated bloodstream infections (CLABSIs) versus other central lines.Objectives:The objective of this study was to compare the CLABSI rate in the first month of therapy after initiating a policy to place PICCs in new patients with severe neutropenia (SN) and Mediports in those with moderate-to-no neutropenia. We also examined thrombosis rates.Design/Method:We prospectively gathered data on new patients for 2.5 years following the policy change and retrospectively for the 2 years prior and compared rates of CLABSIs and thrombosis.Results:CLABSIs decreased in SN patients from 7.52/1000 to 3.11/1000 line days (P=0.33). The CLABSI rate for all patients with SN who had a Mediport was 13.39/1000 versus 4.08/1000 line days for those that received PICCs (P=0.15). The thrombosis rate for Mediport patients was 3.13 clots/1000 versus 7.65/1000 line days for PICC patients, but the difference was not significant (P= 0.11).Conclusion:The differences observed suggest that placing PICCs versus Mediports in new ALL patients with SN may result in a lower incidence of CLABSIs in the first month of therapy without a significant increase in thrombosis.

Original languageEnglish (US)
Pages (from-to)433-437
Number of pages5
JournalJournal of Pediatric Hematology/Oncology
Volume42
Issue number7
DOIs
StatePublished - Oct 1 2020

Keywords

  • CLABSI
  • acute lymphoblastic leukemia
  • central venous lines
  • quality improvement
  • thrombosis

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Hematology
  • Oncology

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