Peripheral Venous Catheter-Related Bloodstream Infection in Hospitalized Children – The Role of Gram-Negative Bacteria

Background: Short term peripheral venous catheter (PVC) is the most commonly used vascular access. Known complications associated with PVC include extravasation and phlebitis. Data regarding PVC-related blood stream infection (BSI) in children are scarce

Methods: A retrospective study conducted in a pediatric tertiary care center. Medical records of children with BSI, admitted to the general pediatric departments, between 2010 and 2019, were examined. Patients with BSI and phlebitis at the PVC site were further characterized and included in the analysis. We excluded patients with central venous catheters, those with other identified source of infection and BSI upon admission. Data collected included: patients` demographics, clinical and microbiological characteristics.

Results: Twenty-six children with PVC-related BSI were identified and included in the analysis. They constituted 0.2% of the total cases of bacteremia during the study period. Median age was 21 months (range, 1.5-211 months) with no sex predominance. Five patients were previously healthy while the others had prior medical conditions. The mean time from catheter insertion to bacteremia was 4.4 (±1.5) days. Eighteen (69%) patients were infected with Gram-negative and six (23%) with Gram-positive bacteria. Mixed Gram-negative and Gram positive, and Candida albicans occurred in one patient (4%) each. Polymicrobial infection occurred in four patients (15 %). The most common bacteria isolated, were klebsiella spp and Staphylococcus aureus.

Conclusions: Gram-negative bacteria is more commonly associated with PVC-related BSI than Gram-positive bacteria. Clinicians should consider a broad-spectrum antibiotic coverage for the empirical treatment of PVC-related BSI in hospitalized pediatric patients.