Optimal management of central venous catheter-related, or -associated, bloodstream infections (CRBSI or CLABSI) in children is not established.
From 345 identified publications, 19 met inclusion criteria (total of 914 attempted salvage strategies).
To achieve successful catheter salvage, in CRBSI the addition of ALT was superior to systemic antibiotics alone. CRBSI recurrence was less common in studies that used ALT compared with systemic antibiotics alone. Recurrences were low with both antibiotic locks and ethanol lock. No clear benefits of ALT addition compared to systemic antibiotic only were found in CLABSI.
The conclusion in this study is that the addition of an antimicrobial lock solution to systemic antibiotic may be beneficial for successful catheter salvage in paediatric patients with CRBSI, depending on aetiology, whereas no statistically significant difference between systemic antibiotic with or without addition of an antimicrobial lock solution was found regarding CLABSI.
Authors :
D. Buonsenso a,b, c, *, G. Salerno d , G. Sodero d , F. Mariani d , L. Pisapia e , C. Gelormini e , M. Di Nardo f , P. Valentini a , G. Scoppettuolo g , D.G. Biasucci e, **
a Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli, Rome, Italy
b Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Universita` Cattolica Del Sacro Cuore, Rome, Italy
c Global Health Research Institute, Istituto di Igiene, Universita` Cattolica Del Sacro Cuore, Rome, Italy
d Institute of Pediatrics, Universita` Cattolica Del Sacro Cuore, Rome, Italy
e Department of Emergency, Intensive Care Medicine and Anesthesiology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy f Pediatric Intensive Care Unit, Children’s Hospital Bambino Gesu`, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy g Department of Infectious Diseases, Fondazione Policlinico Universitario ‘A.Gemelli’ IRCCS, Rome, Italy
* Corresponding author. Address: Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, Rome, Italy. Tel.: þ39 06 3015 6242; fax: þ39 06 3013450.
** Corresponding author. Address: Intensive Care Unit, Department of Emergency, Intensive Care Medicine and Anesthesiology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, Rome, Italy. Tel.: þ39 06 3015 6242; fax: þ39 06 3013450. E-mail addresses: danilobuonsenso@gmail.com (D. Buonsenso), danielebiasucci@gmail.com (D.G. Biasucci).
0195-6701/ @2022 Published by Elsevier Ltd on behalf of The Healthcare Infection Society.
Available online at http://www.sciencedirect.com Journal of Hospital Infection
