Abstract | AIM: METHODS: Data were collected of all the children who received ELT for treatment of CLABSI during 2013-2018 due to failure of standard therapy or multiple catheter-related infections. Univariate and multivariate analyses of risk-factors for ELT failure were performed. Catheter salvage rates were compared to those achieved using systemic antimicrobials alone in an historical control group. RESULTS: A total of 123 ELT episodes among 95 patients were analyzed. The majority of patients had underlying hemato-oncological disorders. Approximately half the episodes occurred in patients with implantable ports. Early and late treatment failure rates of ELT were 16% (20/123) and 7% (9/123), respectively. Overall, successful catheter salvage was achieved in 78% (96/123) of episodes, compared to 54% using systemic antimicrobials alone (P < .001), including mycobacterium, candida, and most staphylococcus aureus infections. Adverse events were reported in 9% (11/123) of episodes and were mostly mechanical. Multivariate analysis identified four risk factors for ELT failure: Gram-positive bacteria, elevated C-reactive protein, signs of tunnel infection, and low absolute neutrophil counts. CONCLUSIONS: Our findings support the use of ELT for catheter salvage in children with CLABSI who failed standard therapy or had multiple catheter-related infections. The identified variables associated with ELT failure may help identify patients who can most benefit from ELT.
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Authors | Liat Ashkenazi-Hoffnung, Naama Shecter, Irit De-Vries, Itzhak Levy, Oded Scheuerman, Havatzelet Yarden-Bilavsky, Yael Bernfeld, Meirav Mor |
Journal | Pediatric blood & cancer
(Pediatr Blood Cancer)
Vol. 68
Issue 5
Pg. e28856
(05 2021)
ISSN: 1545-5017 [Electronic] United States |
PMID | 33352003
(Publication Type: Journal Article)
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Copyright | © 2020 Wiley Periodicals LLC. |
Chemical References |
- Anti-Infective Agents, Local
- Ethanol
|
Topics |
- Anti-Infective Agents, Local
(therapeutic use)
- Catheter-Related Infections
(drug therapy)
- Child
- Child, Preschool
- Ethanol
(therapeutic use)
- Female
- Humans
- Infant
- Male
- Retrospective Studies
- Salvage Therapy
(methods)
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