Factors influencing central line infections in children with acute lymphoblastic leukemia: Results of a single institutional study

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Abstract
Background: We compared the rates of infection in external catheters (ECs) and totally implantable devices (TIDs) and the effect of timing of insertion in children with acute lymphoblastic leukemia (ALL).Procedure: Central line data was collected on all children with ALL referred to the National Guard Hospital, Jeddah. Data was collected retrospectively from 1996 to September 1999 and prospectively thereafter. Only ECs were inserted prior to 1999 subsequently TIDs were preferred.Results: One hundred forty eight children with ALL, mean age 5.1 years had 129 ECs and 70 TIDs inserted for a total of 41,382 catheter days. The overall rate of infective episodes (infections/1,000 catheter days) was 3.43. Of the initial 148 lines 100 developed complications of which 76 (51%) were secondary to an infective episode. Only young age and treatment protocol were risk factors for first line infections (P < 0.05). There was weak evidence that ECs had an earlier time to infection compared to TIDs (P = 0.056).Conclusions: In this study, population central lines were associated with a high rate of infection. Treatment protocol and age were the only significant risk factors when only first lines were considered. Delaying catheter insertion for more than 3 weeks from diagnosis did not reduce the risk of infection.