Highlights
- •Patients with malignancies at risk central line-associated blood infections and subsequent develop complications
- •Catheters are removed during hospitalization in the majority of acutely ill hematology-oncology patients with CLABSI (86.5%) with median time to removal of 11.8 hours
- •Catheter removal greater than 12 hours from culture result trended towards poorer outcomes, although differences were not statistically significant
- •Further investigation is warranted to determine the optimal timing of catheter removal in hematology-oncology with CLABSI
Background
Hematology/oncology patients are at risk for central line-associated bloodstream infections
(CLABSI). The purpose was to determine if infection-related mortality, persistent
bacteremia, and recurrent bacteremia were decreased with early central venous catheter
(CVC) removal.
Methods
A case-matched, retrospective cohort study was conducted comparing patients with early
catheter removal (≤12 hours) to late catheter removal (>12 hours) in hematology/oncology
patients with CLABSI from June 1, 2015 to May 31, 2018. Patients were case-matched
based on intensive care unit admission and presence of shock to control for severity
of illness.
Results/Discussion
Of 148 patients meeting study inclusion, 128 (86.5%), had their CVC removed during
hospitalization (median 11.8 hours). The majority had a hematologic malignancy (90.5%).
Following case-matching, 48 patients remained in each group. The primary outcome of
infection-related mortality, persistent bacteremia, or recurrent bacteremia occurred
more frequently in the late catheter removal group compared to the early catheter
removal group although this was not statistically significant (18.8% vs 8.3%, P = .136).
Conclusions
A lower incidence of infection-related mortality, persistent bacteremia, and recurrent
bacteremia was found in patients early catheter removal; however the sample size was
not adequate to detect statistical differences. Investigators should continue to evaluate
if early catheter removal confers a benefit in a larger patient population.
Graphical abstract
Graphical Abstract
Key Words
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Article Info
Publication History
Published online: November 11, 2021
Footnotes
Conflicts of interest: All authors report no conflicts of interest relevant to this article.
Funding: No financial support was provided relevant to this article.
Identification
Copyright
© 2021 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
