Predictors of early line removal and successful line retention in potential central line-associated bloodstream infections in haematology patients: a retrospective cohort study
- Author(s)
- Thorburn, S; Vogrin, S; Garner, S; Smibert, O; Reynolds, G; Kwong, J; Trubiano, JA; Douglas, AP;
- Journal Title
- Journal of Hospital Infection
- Publication Type
- Research article
- Abstract
- Summary Background Patients with haematologic malignancies are at risk of central line-associated bloodstream infections (CLABSIs) and their adverse outcomes. Patients suitable for a line retention strategy remain ill-defined. Aim To assess factors that would predict failure of line retention in potential CLABSI in haematology patients and to describe behaviours regarding line removal and retention. Methods A single-centre retrospective cohort study of haematology inpatients who developed BSI with a central line in situ was conducted. Line retention was defined as line remaining in situ for ≥72 h post BSI. The primary outcome was failure of line retention, defined as line removal >72 h post BSI or recurrent BSI with the same organism within three months. Predictors of failure of line retention, early line removal (<72 h) and Infectious Diseases Society of America central line-related BSI (CRBSI) (research-definition CRBSI) were assessed using multivariable analysis. Findings Of 288 episodes of BSI included between January 1st, 2018 and December 31st, 2022, 209 cases had retention of line >72 h and 52 of these (24.9%) experienced failed line retention, with prolonged culture positivity predicting this outcome, and source of BSI other than the line associated with successful line retention on multivariate analysis. Seventy-nine (27.4%) had early line removal, with factors associated including intensive care admission, prolonged positive cultures and meeting research-definition CRBSI. Only 27 (9.4%) BSI episodes met the research-definition CRBSI. Conclusion Thorough assessments for alternative sources and use of non-invasive diagnostics including repeat blood cultures before line removal may allow increased appropriate retention of lines.
- Keywords
- Central line-related bloodstream infection; Central line-associated bloodstream infection; Haematology; Leukaemia; Line retention; Line removal
- Department(s)
- Infectious Diseases
- Publisher's Version
- https://doi.org/10.1016/j.jhin.2025.04.019
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Creation Date: 2026-01-16 04:34:23
Last Modified: 2026-01-16 04:35:16