Prevalence of central line-associated bloodstream infections in patients with cancer and subgroup analysis using propensity score matching: A nationwide multicenter study in Italy.
Silvia Belloni, Cristina Arrigoni, Marco Alfredo Arcidiacono and 18 others
PMID 40529454WHAT IT FOUND
In 174 hospitalized adults with cancer and long-term central lines, 5 had CLABSI (2.9%).
The subgroup analysis was too small to show which patients are at higher risk.
Key findings
01Among 174 hospitalized adults with cancer who had long-term central venous access, CLABSI was identified in 5 patients (2.9%).
02Nine patients (5.2%) had long-term central venous access substitution because of previous CLABSI, and five patients (2.9%) had other previous central catheter-related infections.
03After matching 9 patients with CLABSI-related catheter substitution to 9 patients without line infections, cancer type differed (P = 0.045): hematologic cancers were 44.4% in the substitution group and none in the comparison group, while breast cancer was 11.1% and 55.6%.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study used point prevalence, so it estimates how many patients had CLABSI at a single time point and cannot reliably measure how often new infections occur. Only seven hospitals in northern and central Italy were included, and they were chosen by convenience, so the 2.9% prevalence may not apply elsewhere. Only 5 CLABSI cases were found, and only 9 patients had catheter substitution because of previous CLABSI, so the subgroup comparisons were underpowered and exploratory. Infection detection methods differed across hospitals, and some CLABSI cases may have been missed or misclassified. The study did not collect microorganism data, detailed comorbidity index, nutritional status, or performance status, which are relevant to infection risk. Propensity matching balanced some variables but with 9 matched pairs it could also hide differences; the authors did not intend to prove risk factors.
Declared interests
The study was funded by the 5x1000 Humanitas funds, a non-profit foundation, and the publication fee was covered by Italian Ministry of Health Ricerca Corrente funding to IRCCS Humanitas Research Hospital. The authors declared no competing interests.
The easy way to misread this
Do not read the 2.9% CLABSI prevalence or the cancer-type differences after matching as evidence that specific catheters or treatments cause infection. Only 5 CLABSI cases were observed, and the subgroup analysis was exploratory.