دورية أكاديمية
Use of ClearGuard HD caps in pediatric hemodialysis patients.
| العنوان: | Use of ClearGuard HD caps in pediatric hemodialysis patients. |
|---|---|
| المؤلفون: | Nau A; Division of Pediatric Nephrology, Children's Mercy Kansas City, Kansas City, MO, USA. aenau@cmh.edu., Richardson T; Children's Hospital Association, Lenexa, KS, USA., Cardwell D; Division of Pediatric Nephrology, Children's Health Dallas, Dallas, TX, USA., Ehrlich J; Division of Pediatric Nephrology, Stead Family Children's Hospital, University of Iowa, Iowa City, IA, USA., Gattineni J; Division of Pediatric Nephrology, Children's Health Dallas, Dallas, TX, USA., Hanna M; Division of Pediatric Nephrology, Children's Hospital Colorado, Aurora, CO, USA., Keswani M; Division of Pediatric Nephrology, Ann and Robert H. Lurie Children's Hospital, Chicago, IL, USA., Neibauer E; Division of Pediatric Nephrology, Children's Hospital of Wisconsin, Milwaukee, WI, USA., Nitz K; Division of Pediatric Nephrology, Children's Mercy Kansas City, Kansas City, MO, USA., Quigley R; Division of Pediatric Nephrology, Children's Health Dallas, Dallas, TX, USA., Rheault M; Division of Pediatric Nephrology, Children's Minnesota, Minneapolis, MN, USA., Sims R; Division of Pediatric Nephrology, Children's of Alabama, Birmingham, AL, USA., Woo M; Division of Pediatric Nephrology, Stanford Medicine-Children's Health, Lucile Packard Children's Hospital, Palo Alto, CA, USA., Warady BA; Division of Pediatric Nephrology, Children's Mercy Kansas City, Kansas City, MO, USA. |
| المصدر: | Pediatric nephrology (Berlin, Germany) [Pediatr Nephrol] 2024 Jul; Vol. 39 (7), pp. 2171-2175. Date of Electronic Publication: 2024 Jan 25. |
| نوع المنشور: | Journal Article; Multicenter Study |
| اللغة: | English |
| بيانات الدورية: | Publisher: Springer International Country of Publication: Germany NLM ID: 8708728 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1432-198X (Electronic) Linking ISSN: 0931041X NLM ISO Abbreviation: Pediatr Nephrol Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: Berlin : Springer International Original Publication: Berlin : Springer International, c1987- |
| مواضيع طبية MeSH: | Renal Dialysis*/adverse effects , Renal Dialysis*/methods , Catheter-Related Infections*/microbiology , Catheter-Related Infections*/epidemiology , Catheter-Related Infections*/etiology , Central Venous Catheters*/adverse effects , Central Venous Catheters*/microbiology , Kidney Failure, Chronic*/therapy , Chlorhexidine*/therapeutic use , Chlorhexidine*/analogs & derivatives , Chlorhexidine*/administration & dosage, Humans ; Child ; Male ; Female ; Adolescent ; Child, Preschool ; Catheterization, Central Venous/adverse effects ; Catheterization, Central Venous/instrumentation ; Anti-Infective Agents, Local/administration & dosage ; Anti-Infective Agents, Local/therapeutic use |
| مستخلص: | 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. (© 2024. The Authors.) |
| التعليقات: | Erratum in: Pediatr Nephrol. 2024 Aug;39(8):2541. doi: 10.1007/s00467-024-06393-7. (PMID: 38717613) |
| References: | Centers for Disease Control and Prevention (n.d.) 2014 – 2019. Surveillance summary of bloodstream infections in outpatient hemodialysis facilities – National Healthcare Safety Network. https://www.cdc.gov/dialysis/pdfs/BSI-NHSN-2014to2019-508.pdf . Accessed 15 August 2023. Wasik HL, Neu AM, Warady BA, Crawford BL, Richardson T, Gruhler H, Cardwell D, Ruebner RL (2022) The cost of hospitalizations for treatment of hemodialysis catheter-associated blood stream infections in children: a retrospective cohort study. Pediatr Nephrol 38:1915–1923. (PMID: 10.1007/s00467-022-05764-236329285) Brunelli SM, Van Wyck DB, Njord L, Ziebol RJ, Lynch LE, Killion DP (2018) Cluster-randomized trial of devices to prevent catheter-related bloodstream infection. J Am Soc Nephrol 29:1336–1343. (PMID: 10.1681/ASN.2017080870294724155875956) Marsenic O, Rodean J, Richardson T, Swartz S, Claes D, Day JC, Warady BA, Neu AM; Standardizing Care to Improve Outcomes in Pediatric End Stage Renal Disease (SCOPE) Investigators (2020) Tunneled hemodialysis catheter care practices and blood stream infection rate in children: results from the SCOPE collaborative. Pediatr Nephrol 35:135–143. Hymes JL, Mooney A, Van Zandt C, Lynch L, Ziebol R, Killion D (2017) Dialysis catheter–related bloodstream infections: a cluster-randomized trial of the ClearGuard HD antimicrobial barrier cap. Am J Kidney Dis 69:220–227. (PMID: 10.1053/j.ajkd.2016.09.01427839894) Neu AM, Miller MR, Stuart J, Lawlor J, Richardson T, Martz K, Rosenberg C, Newland J, McAfee N, Begin B, Warady BA; SCOPE Collaborative Participants (2014) Design of the standardizing care to improve outcomes in pediatric end stage renal disease collaborative. Pediatr Nephrol 29:1477–1484. |
| فهرسة مساهمة: | Keywords: CA-BSI; Cap; ClearGuard; Hemodialysis; Pediatric |
| المشرفين على المادة: | R4KO0DY52L (Chlorhexidine) 0 (Anti-Infective Agents, Local) |
| تواريخ الأحداث: | Date Created: 20240124 Date Completed: 20240604 Latest Revision: 20240815 |
| رمز التحديث: | 20240816 |
| مُعرف محوري في PubMed: | PMC11147870 |
| DOI: | 10.1007/s00467-023-06273-6 |
| PMID: | 38267590 |
| قاعدة البيانات: | MEDLINE |
Find this article in full text from Springer Verlag. 
Full Text Finder | تدمد: | 1432-198X |
|---|---|
| DOI: | 10.1007/s00467-023-06273-6 |