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Risk of infectious complications in adult patients after allogeneic hematopoietic stem cell transplantation depending on the site of central venous catheter insertion—multicenter prospective observational study, from the IDWP EBMT and Nurses Group of EBMT

Bone Marrow Transplantation volume 56, pages 2929–2933 (2021)Cite this article

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Abstract

The current guidelines for prevention of infections in hematopoietic stem cell transplantation (HSCT) do not specify which central venous catheter (CVC) insertion site should be preferred in allogeneic HSCT recipients—internal jugular vein (IJV) or subclavian vein (SCV). We designed a multicenter prospective observational study comparing the risk of infectious and non-infectious complications between the two most common sites of CVC insertion (IJV and SCV) in allogeneic HSCT. There were in total 232 consecutive patients (86 IJV and 146 SCV) who underwent adult allogeneic HSCT reported from 11 centers in 8 countries. The center independent analysis of central line associated/related blood stream infections with ECDC criteria has shown statistically significant difference favoring SCV (23% IJV vs 13% SCV (OR 2.03 (1.01–4.06), p = 0.047)). The differences in CLABSI per 1000 days of CVC use favored SCV over IJV (7.93/1000 days IJV vs 2.79/1000 days SCV, p = 0.002). The frequency of all non-infectious complications was similar in both arms—13% IJV and 12% SCV (OR 1.1 (0.5–2.5), p = 0.8). This multicenter prospective study showed statistically significant lower confirmed number of CLABSI per 1000 days of CVC use without higher risk of noninfectious complications related to the subclavian insertion site in allogeneic HSCT recipients.

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Fig. 1
Fig. 2: Cumulative percentage of complications according to insertion site for the first CVC used in allo-HSCT.

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Authors and Affiliations

  1. Department of Experimental and Clinical Physiology, Laboratory of Centre for Preclinical Research, Medical University of Warsaw, Warsaw, Poland

    Emilian Snarski

  2. NHS Christie Tr, Manchester, UK

    Jacqui Stringer

  3. Division of Infectious Diseases, Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy

    Małgorzata Mikulska

  4. Division of Infectious Diseases, IRCCS Ospedale Policlinico San Martino, Genoa, Italy

    Małgorzata Mikulska

  5. Department of Hematology and Bone Marrow Transplantation, Poznan University of Medical Sciences, Poznan, Poland

    Lidia Gil

  6. Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy

    Gloria Tridello

  7. EBMT Data Office Leiden, Leiden, The Netherlands

    Paul Bosman, Anne Lippinkhof & Jennifer Hoek

  8. Charles University Hospital, Pilsen, Czech Republic

    Michal Karas

  9. University Medical Centre, Ljubljana, Slovenia

    Samo Zver

  10. Hannover Medical School, Hannover, Germany

    Catherina Lueck

  11. Radboud University Medical Centre, Nijmegen, The Netherlands

    Nicole Blijlevens

  12. Hospital Santa Creu i Sant Pau, Barcelona, Spain

    Iria González

  13. Maria Sklodowska-Curie Institute, Gliwice, Poland

    Małgorzata Ociepa-Wasilkowska

  14. Department of Hematology, Transplantology and Internal Medicine, Central University Hospital, Medical University of Warsaw, Warsaw, Poland

    Michał Górka

  15. ICO—Hospital Duran i Reynals, Barcelona, Spain

    Isabel Sánchez-Ortega

  16. Sahlgrenska University Hospital, Gothenburg, Sweden

    Inger Andersson

  17. Hospital University Marqués de Valdecilla, Santander, Spain

    Lucrecia Yáñez

  18. University Hospital Establishment 1st November, Oran, Algeria

    Mohamed-Amine Bekadja

  19. Collegium Medicum UMK Torun, University Hospital, Bydgoszcz, Poland

    Jan Styczynski

Authors
  1. Emilian Snarski
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  2. Jacqui Stringer
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  4. Lidia Gil
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  20. Jan Styczynski
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Contributions

Concept and design: ES, JS, MM, LG, IA, GT, JS; Acquisition of data: ES, LG, MK, SZ, CL, NB, IG, MOW, MG, ISO, IA, LY, MAB; Analysis and interpretation of data: ES, GT, PB, AL, JH, JS; Drafting of the manuscript: ES; Critical revision of the paper for important intellectual content: JS, MM, LG, AL, JH, MK, CL, NB, IA, JS; Statistical analysis: GT; Provision of study materials or patients: ES, LG, MK, SZ, CL, NB, IG, MOW, MG, ISO, IA, LY, MAB; Administrative, technical, or logistic support: PB, AL, JH, JS; Supervision: MM, JS.

Corresponding authors

Correspondence to Emilian Snarski or Jan Styczynski.

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The authors declare no competing interests.

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Infectious Diseases Working Party and Nurses Group of the European Group for Blood and Marrow Transplantation.

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Snarski, E., Stringer, J., Mikulska, M. et al. Risk of infectious complications in adult patients after allogeneic hematopoietic stem cell transplantation depending on the site of central venous catheter insertion—multicenter prospective observational study, from the IDWP EBMT and Nurses Group of EBMT. Bone Marrow Transplant 56, 2929–2933 (2021). https://doi.org/10.1038/s41409-021-01430-7

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