Document Type
Article
Publication Date
7-2024
Identifier
DOI: 10.1007/s00467-023-06273-6; PMCID: PMC11147870
Abstract
BACKGROUND: Bloodstream infections (BSIs) are a leading cause of hospitalizations and mortality among patients receiving hemodialysis (HD) therapy, especially those with a central venous catheter (CVC) for dialysis access. The use of chlorhexidine impregnated catheter caps (ClearGuard) has been associated with a decrease in the rate of HD catheter-related BSIs (CA-BSIs) in adults; similar data have not been published for children.
METHODS: We compared CA-BSI data from participating centers within the Standardizing Care to Improve Outcomes in Pediatric Endstage Kidney Disease (SCOPE) collaborative based on the center's use of ClearGuard caps for patients with HD catheter access. Centers were characterized as ClearGuard (CG) or non-ClearGuard (NCG) centers, with CA-BSI data pre- and post-CG implementation reviewed. All positive blood cultures in participating centers were reported to the SCOPE collaborative and adjudicated by an infectious disease physician.
RESULTS: Data were available from 1786 SCOPE enrollment forms completed January 2016-January 2022. January 2020 served as the implementation date for analyzing CG versus NCG center data, with this being the time when the last CG center underwent implementation. Post January 2020, there was a greater decrease in the rate of HD CA-BSI in CG centers versus NCG centers, with a decrease from 1.18 to 0.23 and 0.41 episodes per 100 patient months for the CG and NCG centers, respectively (p = 0.002).
CONCLUSIONS: Routine use of ClearGuard caps in pediatric dialysis centers was associated with a reduction of HD CA-BSI rates in pediatric HD patients.
Journal Title
Pediatric nephrology (Berlin, Germany)
Volume
39
Issue
7
First Page
2171
Last Page
2175
MeSH Keywords
Humans; Renal Dialysis; Child; Catheter-Related Infections; Male; Female; Adolescent; Central Venous Catheters; Kidney Failure, Chronic; Chlorhexidine; Child, Preschool; Catheterization, Central Venous; Anti-Infective Agents, Local
Keywords
CA-BSI; Cap; ClearGuard; Hemodialysis; Pediatric
Recommended Citation
Nau A, Richardson T, Cardwell D, et al. Use of ClearGuard HD caps in pediatric hemodialysis patients [published correction appears in Pediatr Nephrol. 2024 May 8. doi: 10.1007/s00467-024-06393-7]. Pediatr Nephrol. 2024;39(7):2171-2175. doi:10.1007/s00467-023-06273-6
Comments
Erratum in
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Publisher's Link: https://link.springer.com/article/10.1007/s00467-023-06273-6