Prophylaxis against Gram Negative & Fungal Infections in Babies with CVAD, Paediatrics

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Abstract

Gram negative and fungal infections are a well recognised cause of morbidity and mortality in immunocompromised babies, children and young people. Both fungi and Gram negative bacteria are recognised environmental organisms.

The campus of the Queen Elizabeth University Hospital and the Royal Hospital for Children, Glasgow have had documented, environmentally acquired, infections in immunocompromised patients.

Prophylaxing against environmental fungal infections is standard practice and there are well established criteria for this. The group considered previous local guidance on prophylaxis within paediatric haemato-oncology, the European Organisation for Research and Treatment of Cancer (EORTC) and Infectious Diseases Society of America (IDSA) guidance and the recent guidance from the Health Protection Surveillance centre in Ireland. 

Prophylaxing against environmental Gram negative bacteria in children has a much smaller evidence base and there is no national or international consensus on whether or how this should be done. There is however published literature which shows the potential for using line locks to decrease the number of gram negative infections in children with cancer.

Standard technique in this document refers to turbulent push pause technique finishing with positive pressure.

NOTE: this guideline is hosted on the NHSGGC Paediatrics Guidelines website. Clicking on the link below will open the guideline in a new window.

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