P-1172. Staphylococcus Aureus Long-Term Catheter-Related Bloodstream Infection in Children: Clinical Features and Outcome

Abstract Background Staphylococcus aureus long-term catheter-related bloodstream infection (LT-CRBI) are a frequent cause of morbidity and mortality. In Staphylococcus aureus LT-CRBI, it is recommended to remove the catheter. However, in pediatrics, management without catheter removal is often necessary. Aims to describe the clinical characteristics and outcome of Staphylococcus aureus LT- CRBI, to cmpare the clinical features and outcome according to removal or retention of the catheter Methods Retrospective cohort study. All patients with Staphylococcus aureus LT-CRBI from 1/1/2018 to 12/31/2022 in a pediatric hospital were included. Episodes of relapse of bacteremia were excluded. LT-CRBI was defined according to CDC criteria. Results Forty-five patients were included. Median age was 80 months (IQR 27-137). All patients had any underlying disease. Most common comorbidities were onco-hematological disease 27 patients (60%), intestinal failure 5 (11%), chronic kidney disease 3 (7%). Thirty-three were under immunosuppressive treatment (73%). Median length of bacteremia was 4 days (IQR 3-5) Five patients presented metastatic infection (11%) including 2 patients with pneumonia, 2 thrombophlebitis and 1 soft tissue infection. Twenty-two catheters (49%) were removed. Reasons for removal were: mechanical dysfunction in 6 patients, catheter was not being used in 5 patients, tunnel or pocket infection in 5, septic shock 3 and persistent bacteremia in 3. Two patients died related to infection (4%). Staphylococcus aureus methicillin sensitive predominated (78%). Comparing patients with catheter removal vs retained: there were no differences in epidemiological, clinical features and outcome (metastatic infection 13% vs 9%, intensive care admission 3% vs 3%, length of bacteremia 4 days in both groups, mortality 20% vs 17%, respectively) Conclusion In this cohort of children with Staphylococcus aureus LT- CRBI, catheters were maintained in 51% of patients. No difference in outcome or complications was observed. Disclosures All Authors: No reported disclosures