Catheter-Related Bloodstream Infections in Pediatric Oncology: Prevention and Treatment

Abstract

Introduction. Prevention and treatment of catheter-related bloodstream infections (CRBI) are one of the priorities in the treatment of children with oncological diseases because the most common way of administration of chemotherapy drug administration is intravenous. Materials and methods. The analysis included 186 cancer patients aged from 2 months to 17 years (mean age 6.4 years) who were established implantable venous port systems (IVPs) with the aim of chemotherapy at the Institute of Pediatric Oncology and Hematology between 2010 and 2015. As IVPs lock solutions saline, saline solution with traces of heparin or Taurolock were used. In cases of the IVPs catheter thrombosis, the flush was performed using saline solution or specialized drug Taurolock U25 000containing 25 000 IU urokinase. Results. CRBI were reported in 10 (5.4%) patients, which required the removal of 1 (0.53%) IVPs; infections of chamber’s pocket — in 5 (2.7%) patients, which required the removal of 4 (2.1%) IVPs; IVPs occlusions due to blood clots — 52 cases in 43 (23.1%) patients. In 9 (90%) out of 10 cases, registered infectious complications were treated with Taurolock. In 2 (20%) cases, taurolidine administration was combined with the antibiotic therapy through the peripheral catheter. In 1 (10%), infection was treated only with antibiotic therapy through the peripheral catheter. In all cases of IVPs thrombosis, the patency was restored. Thus in 5 (9.6%) ou of 52 patients IVPs patency has been restored using saline flush solution, in 47 (90.4%) out of 52 — Taurolock U25000: in 45 (95.7%) patients IVPs patency was restored after the first administration of the drug, in 2 (4.3%) — after the second. Conclusion. Taurolock and Taurolock U25 000 showed their high effectiveness in the treatment of CRBI and catheter thrombosis, which allows us to recommend these drugs for wide administration in clinics dealing with the treatment of cancer patients.