ArticleGMS hygiene and infection control2015
Impact of a modified Broviac maintenance care bundle on bloodstream infections in paediatric cancer patients.
Article in GMS hygiene and infection control, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 19 citations in OpenAlex.
- Implementation frameworks, strategies and outcomes in optimizing central venous access device practice in paediatrics: A scoping review.Journal of advanced nursing · 2025Article
- Clinical Evidence for the Use of Octenidine Dihydrochloride to Prevent Healthcare-Associated Infections and DecreasePathogens (Basel, Switzerland) · 2023Review
- Preclinical evaluation of passive disinfection caps with a long-term catheter for the prevention of catheter-related bloodstream infection in pediatric cancer patients.GMS hygiene and infection control · 2021Article
- Central line bundle including split-septum device and single-use prefilled flushing syringes to prevent port-associated bloodstream infections: a cost and resource-utilization analysis.BMC health services research · 2020Article
- Central Venous Access Devices (CVAD) in Pediatric Oncology Patients-A Single-Center Retrospective Study Over More Than 9 Years.Frontiers in pediatrics · 2019Article
- [Avoidance of complications when dealing with central venous catheters in the treatment of children].Der Anaesthesist · 2017Review
- Surveillance of bloodstream infections in pediatric cancer centers - what have we learned and how do we move on?GMS hygiene and infection control · 2016Review
- In vitro study on the disinfectability of two split-septum needle-free connection devices using different disinfection procedures.GMS hygiene and infection control · 2015Article
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDuring intensive chemotherapy, bloodstream infection (BSI) represents an important complication in paediatric cancer patients. Most patients carry a long-term central venous access device (CVAD). Improved maintenance care of these vascular catheters may decrease the risk of BSI.
methodsIntervention study (adapted CVAD prevention protocol) with two observation periods (P1: 09-2009 until 05-2011; P2: 09-2011 until 05-2013); prospective surveillance of all laboratory confirmed BSIs. In P2, ready to use sterile NaCl 0.9% syringes were used for CVAD flushing and octenidine/isopropanol for the disinfection of catheter hubs and 3-way stopcocks.
resultsDuring P1, 84 patients were included versus 81 patients during P2. There were no significant differences between the two patient populations in terms of median age, gender, underlying malignancy or disease status (first illness or relapse). Nearly all CVADs were Broviac catheters. The median duration from implantation to removal of the CVAD was 192 days (Inter-quartile-range (IQR); 110-288 days) in P1 and 191 days (IQR; 103-270 days) in P2. 28 BSI were diagnosed in 22 patients in P1 (26% of all patients experienced at least one BSI) and 15 BSI in 12 patients in P2 (15% of all patients). The corresponding results for incidence density (ID) were 0.44 (CI95 0.29-0.62) for P1 vs. 0.34 (0.19-0.53) BSI per 100 inpatient days for P2 and for incidence rate (IR) 7.76 (5.16-10.86) in P1 vs. 4.75 (2.66-7.43) BSI per 1,000 inpatient CVAD utilization days. In P1, 9 BSI were caused by CoNS vs. only 2 in P2 (IR 2.49; CI95 0.17-4.17 vs. 0.63; CI95 0.08-1.72). In P1 two BSI (7%) lead to early removal of the device. During P2 one CVAD was prematurely removed due to a Broviac-related BSI (6.7%).
conclusionThe preventive protocol investigated in this study led to a reduction of BSI in paediatric cancer patients. This result was clinically relevant but - due to insufficient power in a single centre observation - the difference did not reach statistical significance. The most pronounced trend in BSI reduction was observed for CoNS infections. Thus, improving maintenance care of the CVAD may result in lower CVAD-linked infection rates. The higher acquisition cost of the ready to use NaCl 0.9% flushing syringes and octenidine/propanol hub disinfection were probably balanced by cost savings in the intervention period.
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