TY - JOUR
T1 - Bacterial bloodstream infections in pediatric allogeneic hematopoietic stem cell recipients before and after implementation of a central line-associated bloodstream infection protocol
T2 - A single-center experience
AU - Chang, Alicia K.
AU - Foca, Marc D.
AU - Jin, Zhezhen
AU - Vasudev, Rahul
AU - Laird, Mary
AU - Schwartz, Sharon
AU - Qureshi, Mahvish
AU - Kolb, Michelle
AU - Levinson, Anya
AU - Bhatia, Monica
AU - Kung, Andrew
AU - Garvin, James
AU - George, Diane
AU - Della-Latta, Phyllis
AU - Whittier, Susan
AU - Saiman, Lisa
AU - Satwani, Prakash
N1 - Publisher Copyright:
© 2016 Association for Professionals in Infection Control and Epidemiology, Inc.
PY - 2016/12/1
Y1 - 2016/12/1
N2 - Introduction There are only few reports describing the influence of central line-associated bloodstream infection (CLABSI) prevention strategies on the incidence of bacterial bloodstream infections (BBSIs). Methods We performed a retrospective cohort study among pediatric recipients of allogeneic hematopoietic stem cell transplantation (allo-HCT) to assess potential changes in BBSI rates during 3 time periods: pre-CLABSI prevention era (era 1, 2004-2005), CLABSI prevention implementation era (era 2, 2006-2009), and maintenance of CLABSI prevention era (era 3, 2010-2012). BBSI from day 0-365 following allo-HCT were studied. The comparison of person-years incidence rates among different periods was carried out by Poisson regression analysis. Results The mean age of patients was 10.0 years. During the study period, 126 (65%) of 190 patients had at least a single BBSI. From day 0-30, day 31-100, day 101-180, and day 181-365, 20%, 28%, 30%, and 17% of patients, respectively, experienced BBSIs. The rate of Staphylococcus epidermidis and gram-negative pathogens significantly declined from 3.16-0.93 and 6.32-2.21 per 100 person-months during era 1 and era 3, respectively (P = .001). Conclusions Patients undergoing allo-HCT during era 3 were associated with decreased risk of BBSI (P = .012). Maintenance of CLABSI protocols by nursing staff and appropriate education of other care providers is essential to lower incidence of BBSI in this high-risk population, and further strategies to decrease infection burden should be studied.
AB - Introduction There are only few reports describing the influence of central line-associated bloodstream infection (CLABSI) prevention strategies on the incidence of bacterial bloodstream infections (BBSIs). Methods We performed a retrospective cohort study among pediatric recipients of allogeneic hematopoietic stem cell transplantation (allo-HCT) to assess potential changes in BBSI rates during 3 time periods: pre-CLABSI prevention era (era 1, 2004-2005), CLABSI prevention implementation era (era 2, 2006-2009), and maintenance of CLABSI prevention era (era 3, 2010-2012). BBSI from day 0-365 following allo-HCT were studied. The comparison of person-years incidence rates among different periods was carried out by Poisson regression analysis. Results The mean age of patients was 10.0 years. During the study period, 126 (65%) of 190 patients had at least a single BBSI. From day 0-30, day 31-100, day 101-180, and day 181-365, 20%, 28%, 30%, and 17% of patients, respectively, experienced BBSIs. The rate of Staphylococcus epidermidis and gram-negative pathogens significantly declined from 3.16-0.93 and 6.32-2.21 per 100 person-months during era 1 and era 3, respectively (P = .001). Conclusions Patients undergoing allo-HCT during era 3 were associated with decreased risk of BBSI (P = .012). Maintenance of CLABSI protocols by nursing staff and appropriate education of other care providers is essential to lower incidence of BBSI in this high-risk population, and further strategies to decrease infection burden should be studied.
KW - Bone marrow transplantation
KW - Children
KW - Sepsis
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U2 - 10.1016/j.ajic.2016.04.229
DO - 10.1016/j.ajic.2016.04.229
M3 - Article
C2 - 27378008
AN - SCOPUS:84998706933
SN - 0196-6553
VL - 44
SP - 1650
EP - 1655
JO - American Journal of Infection Control
JF - American Journal of Infection Control
IS - 12
ER -