Multidrug-Resistant Bacteria colonization as a risk factor for catheter-related Infections in children with cancer.

Thales Pardini Fagundes, Bruna Salgado Rabelo, Camila Mota Guida, Ana Laura Vilela Arfelli, Caroline Mésseder Carvalho Abreu, Iago Souza Wolff, Mariana Antunes Faria Lima, Roberta Maia de Castro Romanelli, Karla Emília de Sá Rodrigues

Resumo


BACKGROUND

OBJECTIVES. The aim of the current study is to analyse which factors are associated to Central-Line associated Bloodstream Infection in children during cancer treatment. METHODS. A prospective study was conducted with children admitted to the university hospital of the Federal University of Minas Gerais. All children and adolescents, up to 18 years of age, with cancer and with a central venous catheter placed were included and followed from March to December 2017. A multivariate logistic regression was performed to check if sex, age, neutrophils and platelet count, hemoglobin levels,  type of neoplasia (hematologic versus solid), local of care, recent use of antibiotic and duration of catheter are predictors of Central Line-Associated Bloodstream Infection, according to Center for Disease Control and Prevention criteria. RESULTS. In the 100 eligible patients (36% girl; median age 8 years), the incidence of infection was 6.01 cases in 1000 catheter-days. The most common isolated microorganisms were Moraxella catarrhalis (3 patients), E. coli (2 patients), S. epidermidis (2 patients). Univariate and multivariate analysis showed a positive association between catheter infections and colonization by multidrug-resistant organisms (OR: 43, CI 95% 7.86–240.6, p < 0.001 and OR: 2.92, CI 95% 9.46–347.41, p = 0.001, respectively). CONCLUSIONS. The colonization by these microrganism at the time of insertion of the central venous catheter might be an important risk factor of catheter infections in children undergoing cancer treatment.

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