Central venous catheter salvage in children with Staphylococcus aureus central line-associated bloodstream infection

Kristine S. Corkum*, Rachel E. Jones, Caroline H. Reuter, Larry K. Kociolek, Elaine Morgan, Timothy B. Lautz

*Corresponding author for this work

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background: Prompt central venous catheter (CVC) removal is currently recommended in children with Staphylococcus aureus central line-associated bloodstream infection (CLABSI). Our objective was to examine the outcome of attempted line salvage in children with S. aureus CLABSI and assess predictors of success. Methods: A single-institution, retrospective cohort study was performed of all children with S. aureus CLABSI between 2012 and 2015. Patients with and without immediate CVC removal (≤ 2 days after first positive culture) were compared. The primary outcome was failed CVC salvage (removal after 3+ days). Results: Seventy-seven children met criteria for S. aureus CLABSI. Immediate CVC removal was performed in 27.3% of patients. Among the 72.7% patients in whom CVC salvage was attempted, 78.6% were successful and 21.4% required delayed CVC removal. Malignancy, short gut syndrome, neutropenia, methicillin-resistant S. aureus, and line type were not associated with salvage failure. No associated morbidity or mortality occurred in patients with a failed salvage attempt. New or recurrent bacteremia occurred in five patients, but three were successfully salvaged a second time. Conclusions: CVC salvage was feasible in the majority of children with S. aureus CLABSI and was not associated with significant complications or attributable mortality as reported in adults.

Original languageEnglish (US)
Pages (from-to)1201-1207
Number of pages7
JournalPediatric Surgery International
Volume33
Issue number11
DOIs
StatePublished - Nov 1 2017

Fingerprint

Central Venous Catheters
Staphylococcus aureus
Infection
Mortality
Methicillin-Resistant Staphylococcus aureus
Bacteremia
Neutropenia
Cohort Studies
Retrospective Studies
Morbidity
Neoplasms

Keywords

  • CLABSI
  • Central venous catheter
  • Children
  • S. aureus
  • Salvage

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Surgery

Cite this

@article{2dbc5353b73b4d418d5572f31dc4797c,
title = "Central venous catheter salvage in children with Staphylococcus aureus central line-associated bloodstream infection",
abstract = "Background: Prompt central venous catheter (CVC) removal is currently recommended in children with Staphylococcus aureus central line-associated bloodstream infection (CLABSI). Our objective was to examine the outcome of attempted line salvage in children with S. aureus CLABSI and assess predictors of success. Methods: A single-institution, retrospective cohort study was performed of all children with S. aureus CLABSI between 2012 and 2015. Patients with and without immediate CVC removal (≤ 2 days after first positive culture) were compared. The primary outcome was failed CVC salvage (removal after 3+ days). Results: Seventy-seven children met criteria for S. aureus CLABSI. Immediate CVC removal was performed in 27.3{\%} of patients. Among the 72.7{\%} patients in whom CVC salvage was attempted, 78.6{\%} were successful and 21.4{\%} required delayed CVC removal. Malignancy, short gut syndrome, neutropenia, methicillin-resistant S. aureus, and line type were not associated with salvage failure. No associated morbidity or mortality occurred in patients with a failed salvage attempt. New or recurrent bacteremia occurred in five patients, but three were successfully salvaged a second time. Conclusions: CVC salvage was feasible in the majority of children with S. aureus CLABSI and was not associated with significant complications or attributable mortality as reported in adults.",
keywords = "CLABSI, Central venous catheter, Children, S. aureus, Salvage",
author = "Corkum, {Kristine S.} and Jones, {Rachel E.} and Reuter, {Caroline H.} and Kociolek, {Larry K.} and Elaine Morgan and Lautz, {Timothy B.}",
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Central venous catheter salvage in children with Staphylococcus aureus central line-associated bloodstream infection. / Corkum, Kristine S.; Jones, Rachel E.; Reuter, Caroline H.; Kociolek, Larry K.; Morgan, Elaine; Lautz, Timothy B.

In: Pediatric Surgery International, Vol. 33, No. 11, 01.11.2017, p. 1201-1207.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Central venous catheter salvage in children with Staphylococcus aureus central line-associated bloodstream infection

AU - Corkum, Kristine S.

AU - Jones, Rachel E.

AU - Reuter, Caroline H.

AU - Kociolek, Larry K.

AU - Morgan, Elaine

AU - Lautz, Timothy B.

PY - 2017/11/1

Y1 - 2017/11/1

N2 - Background: Prompt central venous catheter (CVC) removal is currently recommended in children with Staphylococcus aureus central line-associated bloodstream infection (CLABSI). Our objective was to examine the outcome of attempted line salvage in children with S. aureus CLABSI and assess predictors of success. Methods: A single-institution, retrospective cohort study was performed of all children with S. aureus CLABSI between 2012 and 2015. Patients with and without immediate CVC removal (≤ 2 days after first positive culture) were compared. The primary outcome was failed CVC salvage (removal after 3+ days). Results: Seventy-seven children met criteria for S. aureus CLABSI. Immediate CVC removal was performed in 27.3% of patients. Among the 72.7% patients in whom CVC salvage was attempted, 78.6% were successful and 21.4% required delayed CVC removal. Malignancy, short gut syndrome, neutropenia, methicillin-resistant S. aureus, and line type were not associated with salvage failure. No associated morbidity or mortality occurred in patients with a failed salvage attempt. New or recurrent bacteremia occurred in five patients, but three were successfully salvaged a second time. Conclusions: CVC salvage was feasible in the majority of children with S. aureus CLABSI and was not associated with significant complications or attributable mortality as reported in adults.

AB - Background: Prompt central venous catheter (CVC) removal is currently recommended in children with Staphylococcus aureus central line-associated bloodstream infection (CLABSI). Our objective was to examine the outcome of attempted line salvage in children with S. aureus CLABSI and assess predictors of success. Methods: A single-institution, retrospective cohort study was performed of all children with S. aureus CLABSI between 2012 and 2015. Patients with and without immediate CVC removal (≤ 2 days after first positive culture) were compared. The primary outcome was failed CVC salvage (removal after 3+ days). Results: Seventy-seven children met criteria for S. aureus CLABSI. Immediate CVC removal was performed in 27.3% of patients. Among the 72.7% patients in whom CVC salvage was attempted, 78.6% were successful and 21.4% required delayed CVC removal. Malignancy, short gut syndrome, neutropenia, methicillin-resistant S. aureus, and line type were not associated with salvage failure. No associated morbidity or mortality occurred in patients with a failed salvage attempt. New or recurrent bacteremia occurred in five patients, but three were successfully salvaged a second time. Conclusions: CVC salvage was feasible in the majority of children with S. aureus CLABSI and was not associated with significant complications or attributable mortality as reported in adults.

KW - CLABSI

KW - Central venous catheter

KW - Children

KW - S. aureus

KW - Salvage

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JF - Pediatric Surgery International

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IS - 11

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