Acta Biomedica Scientia

CHILDREN WITH ACUTE LYMPHOBLASTIC AND MYELOID LEUKEMIA AND CENTRAL LINE-ASSOCIATED INFECTIONS: IMPACT OF PERIOPERATIVE ABSOLUTE NEUTROPHIL COUNT

Dr. Puja Deshmukh

pujadeshmukh11@gmail.com

Neutropenia, Absolute Neutrophil Count, Catheter-Related Bloodstream Infection, Tunnelled Central Venous Catheters, Acute Lymphoblastic Leukaemia, Acute Myeloid Leukaemia

The safety of using tunneled central venous catheters for pediatric neutropenic or acute leukemic patients is unknown at the present time. Children with lymphoblastic (ALL) or myeloid leukaemia or myeloid leukemia are investigated for the relationship between the absolute neutrophil count (ANC) and the risk of CLABSIs after TCVC placement. Specifically, we look at patients who are between the ages of five and fourteen (AML). In terms of the Materials as well as the Methods: Children who had been admitted to a tertiary referral hospital for the purpose of receiving a TCVC placement anytime between January 2000 and December 2015 were included in a retrospective observational study. A study was conducted for this purpose. The competing-risk regression model and traditional regression model were both considered utilised by the researchers in order to arrive at an accurate estimation of the impact that perioperative ANC has on the progression of CLABSI. Results: Over the course of 498 consecutive TCVC implants, 350 children received TCVCs. Three hundred and twenty-two of these children were affected by neurotrophic conditions, while 326 of these children were affected by non - neutrophic conditions (65.5%). An interquartile range of 3.1–10.9 years was found in the age distribution of these children, averaging 6.4 years old. Overall, 99,681 catheter days were observed for each TCVC; the interquartile range for observation time was 116.1-265.9. The median observation time for each TCVC was 217.1 days. Neutropenic and nonneutropenic patients did not differ significantly in their rates of early TCVC-related CLABSI within 30 days of TCVC placement (hazard ratio = 1.250, p = 0.502; Hazard ratio = 1.633, p = 0.143). The cause of early CLABSI was found to be female genital morphology (hazard ratio 2.640, p = 0.006) and the use of TCVC to treat relapsed leukemia. Also, we discovered that TCVC use during relapse of leukemia (hazard ratio 2.004, p = 0.003) and use of double-lumen catheters (hazard ratio 2.607, p = 0.003) both increased the risk of leukemia. In children undergoing treatment for acute leukemia who have neutropenia, the TCVC is safe to insert, and there is no increased risk of CLABSI associated with this procedure