(17) Characterization and Assessment of Central Line Associated Bloodstream Infections Requiring Hospitalization in Pediatric Oncology Patients

Location: Exhibit Hall D

First Author Presenting(s)

Mistie Cook, MNSc, RN, CPN, CPHON

Quality/Research RNV
Arkansas Children's Hospital
Austin, Arkansas, United States

Co-Author Not Presenting(s)

JH

Jacquelyn Hovey, MD

Resident Physician
University of Arkansas for Medical Sciences
Little Rock, Arkansas, United States
Andrew D. Tran, MD

Fellow
University of Arkansas for Medical Sciences
Little Rock, Arkansas, United States
Elizabeth Marrero, MSN RN CNOR(E) CIC FAPIC (she/her/hers)

Infection Preventionist II
Arkansas Children's Hospital
Little Rock, Arkansas, United States
JC

Jasmin Cotoco, BS

Medical Student
University of Arkansas for Medical Sciences
North Little Rock, Arkansas, United States
JM

Joana Mack, MD

Associate Professor of Pediatrics
University of Arkansas for Medical Sciences
LITTLE ROCK, Arkansas, United States
Jason Farrar, MD, FAAP

Professor of Pediatrics
University of Arkansas for Medical Sciences
Little Rock, Arkansas, United States

Title: Characterization and Assessment of Central Line Associated Bloodstream Infections Requiring Hospitalization in Pediatric Oncology Patients

Abstract : Pediatric oncology patients require prolonged central venous access to optimize care which increases the risk of central line-associated bloodstream infections (CLABSIs), a significant cause of morbidity and mortality.
This quality improvement project aims to analyze distribution of infection events, identify patterns and outcomes associated with different types of infections, and provide insights for developing targeted infection control measures.
This was an IRB-exempt, single institution study conducted between 2018 and 2025. Patients included had a CLABSI and oncologic diagnosis. Data on infection timing, organism classification, central access type, and patient demographics, including the Area Deprivation Index (ADI), were collected and analyzed.
85 pediatric patients with CLABSI were reviewed. The cohort was 61% female with a median age of 8 years and an equal split of inpatient and ambulatory cases. Most frequent diagnoses were B-acute lymphoblastic leukemia (32.9%), acute myeloid leukemia (22.4%), and neuroblastoma (10.6%). Gram-positive bacteria were most prevalent (52.9%), followed by gram-negative bacteria at 42.4% and fungal organisms at 4.7%. Most common pathogen was P. aeruginosa (18.8%), followed by methicillin-susceptible S. aureus and S. mitis, at 15.6% each. Gram-negative infections were more frequently managed by maintaining the central line (82.8%) compared to gram-positive (64.4%). From a low historical baseline, CLASBI rates fell during the COVID-19 pandemic but spiked 5-fold a year after social restrictions were lifted, a period also corresponding to high nursing turnover. These rates have improved since establishing a dedicated CLASBI rounding team in August 2022 and have returned to baseline. No significant correlation was found between viral respiratory infections, intraoperative antibiotic use, mucosal barrier injury, or ADI. This data highlights the importance of targeted infection control measures and the benefit of coordinated care efforts and well-trained specialty nurses, evidenced by reduction in CLABSIs following implementation of a CLABSI rounding team.