Title :

Salvage strategy for long-term central venous catheter-associated Staphylococcus aureus infections in children: a multicenter retrospective study in France

Author(s) :

Devautour, C. [Auteur]
Université Sorbonne Paris Cité [USPC]
Poey, N. [Auteur]
Lagier, J. [Auteur]
Hospices Civils de Lyon [HCL]
Launay, E. [Auteur]
Cerdac, A. [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Vergnaud, N. [Auteur]
Berneau, P. [Auteur]
Parize, P. [Auteur]
Ferroni, A. [Auteur]
Tzaroukian, L. [Auteur]
Pinhas, Y. [Auteur]
Pinquier, D. [Auteur]
Lorrot, M. [Auteur]
Dubos, Francois [Auteur]
METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694
Caseris, M. [Auteur]
Ouziel, A. [Auteur]
Chalumeau, M. [Auteur]
Cohen, J. F. [Auteur]
Toubiana, J. [Auteur]

Journal title :

Journal of Hospital Infection

Abbreviated title :

J Hosp Infect

Publication date :

2024-06-20

ISSN :

1532-2939

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

Objectives Catheter removal is recommended in adults with Staphylococcus aureus central-line-associated bloodstream infection (CLABSI) but is controversial in children with long-term central venous catheters (LTCVC). We ...
Show more >Objectives Catheter removal is recommended in adults with Staphylococcus aureus central-line-associated bloodstream infection (CLABSI) but is controversial in children with long-term central venous catheters (LTCVC). We evaluated the occurrence of catheter salvage strategy (CSS) in children with S. aureus LTCVC-associated CLABSI and assessed determinants of CSS failure. Methods We retrospectively included children (<18 years) with an LTCVC and hospitalized with S. aureus CLABSI in eight French tertiary-care hospitals (2010–2018). CSS was defined as an LTCVC left in place ≥72 h after initiating empiric antibiotic treatment for suspected bacteraemia. Characteristics of patients were reviewed, and multi-variable logistic regression was performed to identify factors associated with CSS failure (i.e., persistence, recurrence or complications of bacteraemia). Results We included 273 episodes of S. aureus LTCVC-associated CLABSI. CSS was chosen in 194 out of 273 (71%) cases and failed in 74 of them (38%). The main type of CSS failure was the persistence of bacteraemia (39 of 74 cases, 53%). Factors independently associated with CSS failure were: history of catheter infection (adjusted odds ratio (aOR) 3.18, 95% confidence interval (CI) 1.38–7.36), CLABSI occurring on an implantable venous access device (aOR 7.61, 95% CI 1.98–29.20) when compared with tunnelled-cuffed CVC, polymicrobial CLABSI (aOR 3.45, 95% CI 1.25–9.50), and severe sepsis at the initial stage of infection (aOR 4.46, 95% CI 1.18–16.82). Conclusions CSS was frequently chosen in children with S. aureus LTCVC-associated CLABSI, and failure occurred in one-third of cases. The identified risk factors may help clinicians identify children at risk for CSS failure.Show less >

Language :

Anglais

Audience :

Internationale

Popular science :

Non

Administrative institution(s) :

Université de Lille
CHU Lille

Collections :

• METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694

Submission date :

2024-07-05T21:01:03Z
2024-08-27T07:21:21Z