LAUSR

Bloodstream infections are the major cause of morbidity, increased cost, prolonged hospitalization, and mortality in pediatric patients. During treatment, cancer patients require a central vascular access; however, central venous catheters are an important source of bloodstream infections. Rigorous infection control measures and continuous surveillance are required to curb the frequency of these infections. We aimed to identify the causative microorganisms in patients with central line–associated bloodstream infection (CLABSI) in hematology-oncology pediatric patients. All pediatric hematology-oncology patients with CLABSI of Specialty Pediatrics Hospital between January 2016 and September 2019 were reviewed. We defined CLABSI according to the Centers of Disease Control and Prevention definition. Demographic data and microbiologic isolation were analyzed. Seventy-five cases of CLABSI in 432 patients (mean age 9.5 years) were reported. The incidence of CLABSI was 0.9/1000 catheter-days (80,232 total catheter-days). Patients with acute lymphoblastic leukemia had the highest infection density 2.5 /1000 patients-day. Coagulase-negative staphylococci was isolated in 38.5% (30/75) of significant blood culture (CoNS 38.5%); P. aeruginosa in 18.6% (14/75); K. pneumoniae in 10.6% (3/75); E. coli in 6.6% (5/75); and Candida tropicalis in 5.3%(4/75) of cases. Enterobacteriaceae were broad-spectrum betalactamase producers; P. aeruginosa was susceptible to antibiotics betalactamics with antipseudomonal action and Candida spp. was susceptible to azoles. We did not use lock antibiotic therapy and all the catheters were removed once CLABSI was diagnosed. Empiric antibiotic treatment in CLABSI in Specialty Pediatrics Hospital based on these findings includes ceftazidime plus vancomycin. CoNS and P. aeruginosa are the predominant pathogens in CLABSI among pediatric hematology-oncology patient. Antibiotic susceptibility profile has no change during the period of time analyzed, so empiric therapy remains appropriate.