Abstract
Objective Central venous catheter (CVC) colonization is a common problem in the pediatric oncology
department. Initial colonization of CVC by coagulase-negative staphylococci (CoNS),
Staphylococcus aureus, and enterococci is followed by the growth of intraluminal biofilm formation, and
results in antibiotic therapy failure. The removal of the old CVC and insertion of
new CVC is a difficult and expensive procedure in small children with cancer. The
present article aimed to study our treatment results of antibiotic lock therapy (ALT)
with linezolid in pediatric cancer patients.
Methods This study was planned as retrospective presentation of case series with eight pediatric
cancer patients treated with 11 courses of systemic and linezolid lock therapy. Demographic
information, clinical findings, laboratory data, blood culture results, complications,
and outcome were collected for each patient retrospectively and descriptive statistical
methods were used.
Results Prior to treatment, peripheral and CVC blood culture results showed Staphylococcus epidermidis in seven patients and Staphylococcus
hominis in four patients. All pathogens were susceptible to vancomycin and teicoplanin; first-line
treatment was vancomycin in six and teicoplanin in five patients. After first-line
treatment, peripheral blood cultures of all patients were negative, whereas blood
cultures from CVC remained positive. During second-line therapy with linezolid, microbiological
eradication was achieved on the fourth day of treatment in each patient. Median catheter
survival time for all patients was 14 (range: 8–30) months. No side effects were observed
during the treatment and no resistant organisms were documented.
Conclusion Although multicentric prospective controlled trials will be required to provide more
generalizable results, we suggest that systemic antibiotics combined with linezolid
lock therapy used in pediatric cancer patients may be an effective option in treating
catheter-related bloodstream infection (CRBSI) and prolonging CVC survival when CoNS
are identified.
Keywords
catheter-related blood stream infection - linezolid - antibiotic lock therapy - pediatric
cancer patients
