Highlights
- •Having a hematological malignancy is a risk factor for CRI.
- •Whether neutropenia at the moment of catheter placement is a risk factor for CLABSI is uncertain.
- •Among long-term catheters, tunneled, lumen diameter ≥ 7Fr, and multi-lumen devices presented the higher incidence of infections.
- •Ports showed lower rates of CLABSI.
- •Gram-positive bacteria are the most frequent pathogens.
Abstract
Rationale
To understand the risk factors for catheter-related infection during treatment of
pediatric cancer is essential to implement measures to prevent its occurrence.
Background
We performed a comprehensive systematic review of the literature with meta-analysis
to identify and synthesize the main risk factors for catheter-related infection in
children undergoing oncological treatment.
Methods
Systematic searches were conducted in Medline, Embase, Lilacs, and BVS (Biblioteca Virtual em Saúde) until January 2022, following PRISMA guidelines. The search was not limited to language
or dates. Risk factors were divided into host-related, assistance-related, and catheter
types. We also describe the most common pathogens.
Results
Thirteen studies were included in the review. Diagnosis of hematological neoplasm,
the intensity of treatment, blood transfusion in the 4-7 days before the infection,
type of long-term catheters (tunneled externalized catheters, double lumen, greater
diameter), inpatient treatment, and a longer period of hospitalization were the most
consistent risk factors. Metanalysis showed that neutropenia at the moment of catheter
placement is not a risk factor for central-line-associated bloodstream infections,
however, there is high heterogeneity between studies. Staphylococcus epidermidis was the most common pathogen reported.
Conclusions
Understanding risk factors is an essential step to reduce morbidity and mortality
of catheter-related infection. Education for preventive measures, reduction of hospitalization,
wisely choosing the most adequate type of catheter, and the best moment for catheter
insertion may reduce the occurrence of catheter-related infection.
Key Words
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Article Info
Publication History
Published online: May 13, 2022
Publication stage
In Press Journal Pre-ProofFootnotes
Declaration of interests: The authors declare no conflict of interest.
Identification
Copyright
© 2022 Published by Elsevier Inc. on behalf of Association for Professionals in Infection Control and Epidemiology, Inc.
