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Multicenter Study
. 2019 Dec;66(12):e27978.
doi: 10.1002/pbc.27978. Epub 2019 Sep 5.

Outcomes after bloodstream infection in hospitalized pediatric hematology/oncology and stem cell transplant patients

Christopher E Dandoy  1   2 , Tammy Kelley  3 , Aditya H Gaur  4 , Rajaram Nagarajan  1   2 , Kathy Demmel  1 , Priscila Badia Alonso  1   2 , Terri Guinipero  5 , Stephanie Savelli  6 , Hana Hakim  4 , Angie Owings  4 , Kasiani Myers  1   2 , Victor Aquino  7 , Carol Oldridge  8 , Mary Lynn Rae  9 , Katharine Schjodt  10 , Tracie Kilcrease  11 , Michelle Scurlock  12 , Ann M Marshburn  13 , Margaret Hill  14 , Mary Langevin  15 , Jennifer Lee  15 , Raven Cooksey  16 , Amir Mian  8 , Shelby Eckles  7 , Justin Ferrell  1   2 , Javier El-Bietar  1   2 , Adam Nelson  1   2 , Brian Turpin  1   2 , Frederick S Huang  17 , John Lawlor  18 , Megan Esporas  18 , Adam Lane  1   2 , Jeffrey Hord  6 , Amy L Billett  19
Affiliations
Multicenter Study

Outcomes after bloodstream infection in hospitalized pediatric hematology/oncology and stem cell transplant patients

Christopher E Dandoy et al. Pediatr Blood Cancer. 2019 Dec.

Abstract

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.

Keywords: BMT; ICU; Infections; immunocompromised hosts; infections in immunocompromised hosts; outcomes research; pediatric hematology/oncology.

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Conflict of interest statement

CONFLICTS OF INTEREST

The authors have no financial relationships or conflicts of interest relevant to this article to disclose.

Figures

FIGURE 1
FIGURE 1
Bloodstream infections from 17 centers (November 1, 2011, through April 30, 2015)
See this image and copyright information in PMC

References

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