{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T20:39:10Z","timestamp":1762979950641},"reference-count":8,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2013,2,26]],"date-time":"2013-02-26T00:00:00Z","timestamp":1361836800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Paediatrics Child Health"],"published-print":{"date-parts":[[2013,3]]},"abstract":"Aims<\/jats:title>Fully implantable central venous access devices (CVAD<\/jats:styled-content>s) can offer long\u2010term reliable venous access to facilitate regular factor replacement therapy in haemophilia. However, CVAD<\/jats:styled-content>\u2010related infection remains a major deterrent to the optimal use of CVAD<\/jats:styled-content> in this population. This report represents the first review of CVAD<\/jats:styled-content> use in haemophilia in A<\/jats:styled-content>ustralia and aims to examine the rate of complications including CVAD<\/jats:styled-content>\u2010related infections.<\/jats:p><\/jats:sec>Methods<\/jats:title>A retrospective review of medical records was conducted of all haemophilic patients with fully implantable CVADs<\/jats:styled-content> at the R<\/jats:styled-content>oyal C<\/jats:styled-content>hildren's H<\/jats:styled-content>ospital (RCH<\/jats:styled-content>), Melbourne, between 1 J<\/jats:styled-content>une 1992 and 30 J<\/jats:styled-content>une 2009. CVAD<\/jats:styled-content>\u2010related bloodstream infection was defined based on the guidelines from the C<\/jats:styled-content>entre of D<\/jats:styled-content>isease C<\/jats:styled-content>ontrol and V<\/jats:styled-content>ictoria N<\/jats:styled-content>ational N<\/jats:styled-content>osocomial I<\/jats:styled-content>nfection S<\/jats:styled-content>urveillance. To further enhance identification of CVAD<\/jats:styled-content>\u2010related infection in this study, a third criterion of \u2018suspected infection\u2019 was added by the authors.<\/jats:p><\/jats:sec>Results<\/jats:title>Eighty\u2010one CVADs<\/jats:styled-content> in 56 patients were managed at the RCH<\/jats:styled-content> during this time period resulting in a combined study period of 94\u2009756 CVAD<\/jats:styled-content> days. Median age at first CVAD<\/jats:styled-content> insertion = 2.16 years (range 0.66 to 13.98 years). CVADs<\/jats:styled-content> were inserted predominantly due to difficult venous access and prophylaxis initiation (70.4%). Median life\u2010span of a CVAD<\/jats:styled-content> was 1227 days, equivalent to 3.36 years (n<\/jats:italic> = 50; range 0.22 to 9.44 years). Fifty\u2010seven CVAD<\/jats:styled-content>\u2010related infections occurred in 37 CVADs<\/jats:styled-content> (46.3%) in 29 patients (51.8%). Overall incidence of confirmed CVAD<\/jats:styled-content>\u2010related bloodstream infection = 0.42 per 1000 CVAD<\/jats:styled-content> days (95% confidence interval (CI<\/jats:styled-content>): 0.31 to 0.58 per 1000 CVAD<\/jats:styled-content> days) and indicate better performance compared with the published benchmark of 0.66 per 1000 CVAD<\/jats:styled-content> days (0.44 to 0.97 per 1000 CVAD<\/jats:styled-content> days). The incidence of both confirmed (criteria 1, 2) and suspected (criterion 3) CVAD<\/jats:styled-content>\u2010related infection is 0.60 per 1000 CVAD<\/jats:styled-content> days (95% CI<\/jats:styled-content>: 0.46 to 0.78), which is comparable to the international benchmark. The majority of CVAD<\/jats:styled-content>\u2010related infections (73.7%) were successfully treated with intravenous antimicrobials without necessitating CVAD<\/jats:styled-content> removal. K<\/jats:styled-content>lebsiella pneumoniae<\/jats:italic> was the most common organism found in positive blood cultures.<\/jats:p><\/jats:sec>Conclusion<\/jats:title>CVAD<\/jats:styled-content>\u2010related infection in this Australian population was comparable to rates described in the medical literature. Ongoing surveillance for infection rates is important to provide an up\u2010to\u2010date assessment of risks associated with CVAD<\/jats:styled-content> use in this population.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jpc.12112","type":"journal-article","created":{"date-parts":[[2013,2,26]],"date-time":"2013-02-26T12:09:36Z","timestamp":1361880576000},"page":"242-245","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Central venous access device\u2010related infections in patients with haemophilia"],"prefix":"10.1111","volume":"49","author":[{"given":"Zhi Han","family":"Yeoh","sequence":"first","affiliation":[{"name":"Henry Ekert Haemophilia Treatment Centre Royal Children's Hospital Melbourne Victoria Australia"},{"name":"Melbourne Medical School University of Melbourne Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Janine","family":"Furmedge","sequence":"additional","affiliation":[{"name":"Henry Ekert Haemophilia Treatment Centre Royal Children's Hospital Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julia","family":"Ekert","sequence":"additional","affiliation":[{"name":"Henry Ekert Haemophilia Treatment Centre Royal Children's Hospital Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joe","family":"Crameri","sequence":"additional","affiliation":[{"name":"Department of Surgery Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nigel","family":"Curtis","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit Department of General Medicine Royal Children's Hospital Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chris","family":"Barnes","sequence":"additional","affiliation":[{"name":"Henry Ekert Haemophilia Treatment Centre Royal Children's Hospital Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2013,2,26]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00270-006-0021-z"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(97)10006-X"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa067659"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.2007.06703.x"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2516.2003.00840.x"},{"key":"e_1_2_7_7_1","first-page":"s12","article-title":"Barriers to primary prophylaxis in haemophilic children: the issue of the venous access","volume":"6","author":"Santagostino E","year":"2008","journal-title":"Blood Transfus."},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11908-005-0042-9"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2516.2003.00793.x"}],"container-title":["Journal of Paediatrics and Child Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fjpc.12112","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fjpc.12112","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jpc.12112","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,15]],"date-time":"2023-10-15T04:27:54Z","timestamp":1697344074000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jpc.12112"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,2,26]]},"references-count":8,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2013,3]]}},"alternative-id":["10.1111\/jpc.12112"],"URL":"https:\/\/doi.org\/10.1111\/jpc.12112","archive":["Portico"],"relation":{},"ISSN":["1034-4810","1440-1754"],"issn-type":[{"value":"1034-4810","type":"print"},{"value":"1440-1754","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,2,26]]},"assertion":[{"value":"2012-06-09","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2013-02-26","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}