Identifying Odds of Bloodstream Infection in Repaired Silastic Central Venous Catheters in a Pediatric Population
Nurse-led research is investigating infection in repaired central venous catheters. Eight out of 9 retrospective studies found no increased risk of infection with a repair. Broken catheters outside the hospital setting may be at risk for bacteremia. There are low frequencies of CLABSI or bacteremia and exposure to line repair. Silicone central venous catheters (CVCs) that weaken or rupture are reparable using a commercial repair kit. A literature review exploring bloodstream infections in repaired CVCs identified many findings indicating low or no increased risk of infection. This study aimed to understand pediatric patients’ risk of bloodstream infection with repaired Hickman or Broviac catheters. A matched retrospective case-control study examined central line–associated bloodstream infection (CLABSI) or bacteremia in two separately matched cohorts of patients with silicone-type catheters. Controls were patients with CVCs selected from 2016 to 2019 and were matched to cases based on age group (older or younger than 3 years). Conditional logistic regression models calculated odds ratios (OR), with 95% confidence intervals (CI) representing the odds of a line repair occurring 30 days before an event among cases versus controls. In 61 CLABSI cases and 104 controls, the OR of exposure to a line repair was 0.43; 95% CI, 0.05–3.87, P = 0.45. In comparing 49 bacteremia cases to 109 controls, the OR of exposure to a line repair was 6.69; 95% CI, 0.69–8, P = 0.10. The frequency of CVC repair was relatively low. Associations between repair and infection were not detected in either cohort; however, odds of line repair exposure appeared to be higher in bacteremia cases (a trend not observed in the CLABSI cohort). More extensive studies examining the demographic and clinical characteristics of the CVC repair population will be critical for improving outcomes.Highlights
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