Pediatrics Medical News about catheter-related bacteremia

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Prevention of catheter-related bacteremia in children on hemodialysis: time for action
Pediatric Nephrology, 08/07/09

Stefanidis CJ. – It is suggested that the use of antimicrobial locks should be considered in children who are at high risk of developing CRB, with caution for their long–term use, because of the possibility of bacterial resistance. Now is the time for action, and all preventive steps should be performed simultaneously to minimize the risk of CRB.

Exclusive Author Commentary
Constantinos J. Stefanidis, 08/14/09

Creation and preservation of an adequate vascular hemodialysis access is a critical issue for children with end-stage renal disease. Catheter-related bacteremia (CRB) in children in many hemodialysis centers remains a major concern, because of the associated high morbidity and significant increase of hospital cost. Although an arteriovenous fistula is associated with lower infection rates, tunnelled cuffed catheters (TCC) are used more frequently and is well known that CRB has been the major complication of the use of TCCs. An important step for CRB prevention is to decrease the use of TCC, especially in children on long term dialysis, who are at high risk to develop CRB. Implementation of effective strategies for prevention of contamination of the catheter hub should be a priority. The appropriate recording and evaluation of CRB rates are important for the assessment of preventive policies. The successful management of a CRB is essential for the prevention of recurrence of bacteremia. Finally there is enough evidence to support the prophylactic use of AML in a number of children with increased risk to develop CRB. All the preventive steps should be performed simultaneously in order to minimise the risk of CRB. All the preventive steps should be performed simultaneously in order to minimise the risk of CRB.

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