The Turkish Journal of Pediatrics 2019 , Vol 61 , Num 6
Is antibiotic lock therapy effective for the implantable longterm catheter-related bloodstream infections in children?
Tuğçe Tural Kara 1 ,Halil Özdemir 1 ,Tuğba Erat 1 ,Aysun Yahşi 1 ,Ahmet Derya Aysev 2 ,Nurdan Taçyıldız 3 ,Emel Ünal 3 ,Talia İleri 4 ,Elif İnce 4 ,Şule Haskoloğlu 5 ,Ergin Çiftçi 1 ,Erdal İnce 1
1 Departments of Pediatric Infectious Diseases, Ankara University Faculty of Medicine, Ankara, Turkey
2 Departments of Microbiology Laboratory, Ankara University Faculty of Medicine, Ankara, Turkey
3 Departments of Pediatric Oncology, Ankara University Faculty of Medicine, Ankara, Turkey
4 Departments of Pediatric Hematology, Ankara University Faculty of Medicine, Ankara, Turkey
5 Departments of Pediatric Immunology-Allergy, Ankara University Faculty of Medicine, Ankara, Turkey
DOI : 10.24953/turkjped.2019.06.011 Tural Kara T, Özdemir H, Erat T, Yahşi A, Aysev AD, Taçyıldız N, Ünal E, İleri T, İnce E, Haskoloğlu Ş, Çiftçi E, İnce E. Is antibiotic lock therapy effective for the implantable long-term catheter-related bloodstream infections in children? Turk J Pediatr 2019; 61: 895-904.

Catheter-related bloodstream infections (CRBSIs) are an important problem in pediatric patients with central venous catheters. This study aimed to determine the incidence of CRBSIs, responsible pathogens and outcomes of antibiotic lock treatment (ALT) in pediatric patients. Between January 2010 and November 2015 all hospitalized pediatric hematology, oncology and immunology patients diagnosed with CRBSIs were retrospectively analyzed.

Seventy-eight CRBSI episodes were detected in 60 pediatric patients. The incidence of CRBSIs was 4.20/1000 catheter days. The most frequently detected pathogen was methicillin-resistant coagulase-negative Staphylococcus. Pseudomonas aeruginosa, Klebsiella spp., and Escherichia coli were other commonly isolated microorganisms. ALT was administered in 42 patients. The success rate of ALT was 81% (34/42). Catheter was removed without ALT in 36 episodes. Common reasons for catheter removal were sepsis and causative microorganisms which had high probability of biofilm formation.

CRBSIs are an important cause of morbidity and mortality in pediatric patients. ALT is safe and effective. It is possible to obtain satisfactory results when ALT is used with intravenous systemic antibiotics for CRBSIs, though in some cases catheter removal is necessary. ALT helps to prevent unnecessary catheter removal in pediatric patients. Keywords : Antibiotic lock therapy, catheter-related bloodstream infections, central venous catheter

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