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Outcomes after bloodstream infection in hospitalized pediatric hematology/oncology and stem cell transplant patients
Author(s) -
Dandoy Christopher E.,
Kelley Tammy,
Gaur Aditya H.,
Nagarajan Rajaram,
Demmel Kathy,
Alonso Priscila Badia,
Guinipero Terri,
Savelli Stephanie,
Hakim Hana,
Owings Angie,
Myers Kasiani,
Aquino Victor,
Oldridge Carol,
Rae Mary Lynn,
Schjodt Katharine,
Kilcrease Tracie,
Scurlock Michelle,
Marshburn Ann M.,
Hill Margaret,
Langevin Mary,
Lee Jennifer,
Cooksey Raven,
Mian Amir,
Eckles Shelby,
Ferrell Justin,
ElBietar Javier,
Nelson Adam,
Turpin Brian,
Huang Frederick S.,
Lawlor John,
Esporas Megan,
Lane Adam,
Hord Jeffrey,
Billett Amy L.
Publication year - 2019
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.27978
Subject(s) - medicine , hematology , hematopoietic stem cell transplantation , intensive care unit , adverse effect , transplantation , population , retrospective cohort study , bloodstream infection , pediatrics , intensive care medicine , emergency medicine , environmental health
Background Pediatric hematology/oncology (PHO) patients receiving therapy or undergoing hematopoietic stem cell transplantation (HSCT) often require a central line and are at risk for bloodstream infections (BSI). There are limited data describing outcomes of BSI in PHO and HSCT patients. Methods This is a multicenter ( n = 17) retrospective analysis of outcomes of patients who developed a BSI. Centers involved participated in a quality improvement collaborative referred to as the Childhood Cancer and Blood Disorder Network within the Children's Hospital Association. The main outcome measures were all‐cause mortality at 3, 10, and 30 days after positive culture date; transfer to the intensive care unit (ICU) within 48 hours of positive culture; and central line removal within seven days of the positive blood culture. Results Nine hundred fifty‐seven BSI were included in the analysis. Three hundred fifty‐four BSI (37%) were associated with at least one adverse outcome. All‐cause mortality was 1% ( n = 9), 3% ( n = 26), and 6% ( n = 57) at 3, 10, and 30 days after BSI, respectively. In the 165 BSI (17%) associated with admission to the ICU, the median ICU stay was four days (IQR 2‐10). Twenty‐one percent of all infections ( n = 203) were associated with central line removal within seven days of positive blood culture. Conclusions BSI in PHO and HSCT patients are associated with adverse outcomes. These data will assist in defining the impact of BSI in this population and demonstrate the need for quality improvement and research efforts to decrease them.