{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T22:21:18Z","timestamp":1777674078695,"version":"3.51.4"},"reference-count":34,"publisher":"Cambridge University Press (CUP)","issue":"2","license":[{"start":{"date-parts":[[2022,4,25]],"date-time":"2022-04-25T00:00:00Z","timestamp":1650844800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Infect. Control Hosp. Epidemiol."],"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S0899823X22000824_as1\"><jats:title>Background:<\/jats:title><jats:p>Bloodstream infections (BSIs) are a frequent cause of morbidity in patients with acute myeloid leukemia (AML), due in part to the presence of central venous access devices (CVADs) required to deliver therapy.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X22000824_as2\"><jats:title>Objective:<\/jats:title><jats:p>To determine the differential risk of bacterial BSI during neutropenia by CVAD type in pediatric patients with AML.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X22000824_as3\"><jats:title>Methods:<\/jats:title><jats:p>We performed a secondary analysis in a cohort of 560 pediatric patients (1,828 chemotherapy courses) receiving frontline AML chemotherapy at 17 US centers. The exposure was CVAD type at course start: tunneled externalized catheter (TEC), peripherally inserted central catheter (PICC), or totally implanted catheter (TIC). The primary outcome was course-specific incident bacterial BSI; secondary outcomes included mucosal barrier injury (MBI)-BSI and non-MBI BSI. Poisson regression was used to compute adjusted rate ratios comparing BSI occurrence during neutropenia by line type, controlling for demographic, clinical, and hospital-level characteristics.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X22000824_as4\"><jats:title>Results:<\/jats:title><jats:p>The rate of BSI did not differ by CVAD type: 11 BSIs per 1,000 neutropenic days for TECs, 13.7 for PICCs, and 10.7 for TICs. After adjustment, there was no statistically significant association between CVAD type and BSI: PICC incident rate ratio [IRR] = 1.00 (95% confidence interval [CI], 0.75\u20131.32) and TIC IRR = 0.83 (95% CI, 0.49\u20131.41) compared to TEC. When MBI and non-MBI were examined separately, results were similar.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X22000824_as5\"><jats:title>Conclusions:<\/jats:title><jats:p>In this large, multicenter cohort of pediatric AML patients, we found no difference in the rate of BSI during neutropenia by CVAD type. This may be due to a risk-profile for BSI that is unique to AML patients.<\/jats:p><\/jats:sec>","DOI":"10.1017\/ice.2022.82","type":"journal-article","created":{"date-parts":[[2022,4,25]],"date-time":"2022-04-25T02:42:14Z","timestamp":1650854534000},"page":"222-229","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":4,"title":["Risk of bacterial bloodstream infection does not vary by central-line type during neutropenic periods in pediatric acute myeloid leukemia"],"prefix":"10.1017","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2474-3031","authenticated-orcid":false,"given":"Caitlin W.","family":"Elgarten","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7959-1445","authenticated-orcid":false,"given":"William R.","family":"Otto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5274-6048","authenticated-orcid":false,"given":"Luke","family":"Shenton","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Madison T.","family":"Stein","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph","family":"Horowitz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9775-2839","authenticated-orcid":false,"given":"Catherine","family":"Aftandilian","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6053-8521","authenticated-orcid":false,"given":"Staci D.","family":"Arnold","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5602-7059","authenticated-orcid":false,"given":"Kira O.","family":"Bona","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2873-6058","authenticated-orcid":false,"given":"Emi","family":"Caywood","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7183-7826","authenticated-orcid":false,"given":"Anderson B.","family":"Collier","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0947-104X","authenticated-orcid":false,"given":"M. Monica","family":"Gramatges","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Meret","family":"Henry","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Craig","family":"Lotterman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kelly","family":"Maloney","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9323-8979","authenticated-orcid":false,"given":"Arunkumar J.","family":"Modi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8905-4149","authenticated-orcid":false,"given":"Amir","family":"Mian","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5574-1779","authenticated-orcid":false,"given":"Rajen","family":"Mody","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2505-8885","authenticated-orcid":false,"given":"Elaine","family":"Morgan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth A.","family":"Raetz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anupam","family":"Verma","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6636-3870","authenticated-orcid":false,"given":"Naomi","family":"Winick","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3806-6019","authenticated-orcid":false,"given":"Jennifer J.","family":"Wilkes","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4462-200X","authenticated-orcid":false,"given":"Jennifer C.","family":"Yu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7482-5644","authenticated-orcid":false,"given":"Richard","family":"Aplenc","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8224-4281","authenticated-orcid":false,"given":"Brian T.","family":"Fisher","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2020-5153","authenticated-orcid":false,"given":"Kelly D.","family":"Getz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2022,4,25]]},"reference":[{"key":"S0899823X22000824_ref4","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.2010.08389.x"},{"key":"S0899823X22000824_ref25","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.24426"},{"key":"S0899823X22000824_ref28","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cis774"},{"key":"S0899823X22000824_ref20","doi-asserted-by":"publisher","DOI":"10.3109\/08880018.2013.778379"},{"key":"S0899823X22000824_ref32","doi-asserted-by":"publisher","DOI":"10.2169\/internalmedicine.56.7625"},{"key":"S0899823X22000824_ref34","doi-asserted-by":"publisher","DOI":"10.1007\/s00277-016-2798-4"},{"key":"S0899823X22000824_ref6","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.26254"},{"key":"S0899823X22000824_ref24","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.22942"},{"key":"S0899823X22000824_ref1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.leu.2403188"},{"key":"S0899823X22000824_ref12","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2021.28385"},{"key":"S0899823X22000824_ref21","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2016.06.052"},{"key":"S0899823X22000824_ref17","doi-asserted-by":"publisher","DOI":"10.1097\/INF.0000000000000060"},{"key":"S0899823X22000824_ref22","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.25281"},{"key":"S0899823X22000824_ref18","doi-asserted-by":"publisher","DOI":"10.1007\/s00520-008-0561-7"},{"key":"S0899823X22000824_ref19","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.21497"},{"key":"S0899823X22000824_ref10","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.26053"},{"key":"S0899823X22000824_ref33","doi-asserted-by":"publisher","DOI":"10.1007\/s12185-011-0928-2"},{"key":"S0899823X22000824_ref14","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2000.18.9.1845"},{"key":"S0899823X22000824_ref29","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2018.12512"},{"key":"S0899823X22000824_ref31","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhin.2005.08.019"},{"key":"S0899823X22000824_ref13","unstructured":"13. National Healthcare Safety Network. Bloodstream infection event (central-line\u2013associated bloodstream infection and non\u2013central-line\u2013associated bloodstream infection). Centers for Disease Control and Prevention website. https:\/\/www.cdc.gov\/nhsn\/pdfs\/pscmanual\/4psc_clabscurrent.pdf. Published 2021. Accessed April 11, 2021."},{"key":"S0899823X22000824_ref5","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijid.2009.02.021"},{"key":"S0899823X22000824_ref11","doi-asserted-by":"publisher","DOI":"10.1007\/s10096-012-1652-4"},{"key":"S0899823X22000824_ref16","doi-asserted-by":"publisher","DOI":"10.3109\/10428194.2012.742520"},{"key":"S0899823X22000824_ref15","doi-asserted-by":"publisher","DOI":"10.1097\/MPH.0b013e31822817a6"},{"key":"S0899823X22000824_ref30","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0142(19970915)80:6<1009::AID-CNCR1>3.0.CO;2-4"},{"key":"S0899823X22000824_ref3","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2007-05-091942"},{"key":"S0899823X22000824_ref26","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.20.00591"},{"key":"S0899823X22000824_ref8","doi-asserted-by":"publisher","DOI":"10.4065\/81.9.1159"},{"key":"S0899823X22000824_ref7","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.24107"},{"key":"S0899823X22000824_ref9","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2013-0302"},{"key":"S0899823X22000824_ref23","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdi111"},{"key":"S0899823X22000824_ref27","doi-asserted-by":"publisher","DOI":"10.1093\/jpids\/piab036"},{"key":"S0899823X22000824_ref2","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.21613"}],"container-title":["Infection Control &amp; Hospital Epidemiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0899823X22000824","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,31]],"date-time":"2023-10-31T12:04:47Z","timestamp":1698753887000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0899823X22000824\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,4,25]]},"references-count":34,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2023,2]]}},"alternative-id":["S0899823X22000824"],"URL":"https:\/\/doi.org\/10.1017\/ice.2022.82","relation":{},"ISSN":["0899-823X","1559-6834"],"issn-type":[{"value":"0899-823X","type":"print"},{"value":"1559-6834","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,4,25]]},"assertion":[{"value":"\u00a9 The Author(s), 2022. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}}]}}