Pediatrics · Oncology · 3 h ago
Catheter removal linked to fewer complications in pediatric cancer patients with S aureus bacteremia
A multicenter retrospective study examined 322 episodes of Staphylococcus aureus bloodstream infection in pediatric oncology patients from 2005 to 2022. Among episodes with a central venous catheter, complications were more common when catheter salvage was attempted than when the catheter was removed.
- Complications occurred in 25.3% with salvage versus 16.2% with removal.
- Catheter salvage was associated with higher adjusted odds of complications.
- The retrospective study included 322 infection episodes over 17 years.
Researchers reviewed pediatric oncology patients with S aureus bloodstream infections at multiple centers between 2005 and 2022. They assessed major complications occurring from 72 hours to 6 months after the initial positive culture, including recurrent bloodstream infection, deep infection, meningitis, endocarditis, osteomyelitis, and S aureus–related death. Analyses used multivariable logistic regression and propensity score weighting for catheter removal.
Of 322 infection episodes, 292 (90.7%) involved a central venous catheter at presentation. The primary outcome occurred in 21.2% of these episodes: 25.3% in the catheter-salvage group (41/161) and 16.2% in the removal group (21/130). Catheter salvage was independently associated with complications (OR 3.37, 95% CI 2.08–5.61), including in both the short-term (OR 21.8, 95% CI 7.09–95.4) and late periods (OR 1.83, 95% CI 1.06–3.18).
The findings support existing recommendations to remove catheters in this population, but the retrospective design cannot establish causality. The results concern pediatric cancer patients with S aureus bloodstream infection and may not apply to other patient groups or infections.
In practice
For children with cancer and S aureus bloodstream infection who have a central venous catheter, this multicenter retrospective study found fewer major complications when the catheter was removed than when salvage was attempted. The association persisted in adjusted analyses and was observed in short-term and later follow-up. These findings support existing catheter-removal recommendations for this population, but do not prove that removal itself caused the difference; treatment decisions should account for the individual clinical context. The study does not establish applicability to other patient groups or pathogens.
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Pediatrics: Complications in Pediatric Cancer Patients With Staphylococcus aureus Bloodstream Infection ↗This is an automated AI-condensed summary that has not yet been reviewed by an editor. Always consult the full item at the original source.