DEVICE-ASSOCIATED INFECTIONS IN CHILDREN WITH HEMATOLOGIC MALIGNANCIES TREATED AT A REFERRAL SERVICE: A RETROSPECTIVE STUDY OF 2024

Hematologic malignancies are characterized by clonal expansion of hematopoietic component cells and are highly prevalent in childhood. Treating this set of diseases requires the use of venous devices for administration of cytomielotoxic drugs. However, these devices can be infected by various microorganisms, such as fungi and bacteria, representing an additional risk to affected patients. This work aims to describe the profile of infections found in children diagnosed with hematologic malignancy and using deep venous devices. Retrospective, descriptive study analyzing data obtained from an oncology referral service in Maranhão. The type of infecting microorganism and its susceptibility profile were described from venous devices of pediatric patients with hematologic cancer in 2024. Microorganisms were isolated from device-drawn blood in 65 patients, with 35.4% (23) infected by Gram-positive bacteria, 40% (26) by Gram-negative bacteria, and 24.6% (16) by fungi. The device most affected by Gram-positives and fungi was the Peripherally Inserted Central Catheter, while Gram-negatives were more present in the Central Venous Catheter. The most frequent Gram-positive was Staphylococcus epidermidis (21.74%), and among Gram-negatives, Klebsiella pneumoniae (26.92%). Among fungi, Candida parapsilosis was the most frequent (56.25%). Regarding susceptibility: Gram-positives (coagulase-negative Staphylococcus ) had oxacillin resistance in 84.5% (11); Gram-negatives: Klebsiella pneumoniae (7) with 2 showing carbapenemase production resistant to meropenem and 3 with ESBL production resistant to cephalosporins. Among fungi, one Candida parapsilosis isolate was resistant to Amphotericin B. Venous devices pose a risk of microorganism proliferation, with diverse flora, reinforcing the need for proper management during insertion and maintenance to reduce infectious events, especially in immunosuppressed patients due to hematologic malignancy or other causes. The antimicrobial resistance found strengthens the need for rational antibiotic use, given that the resistance observed in the sample could be minimized with lower prior exposure of bacteria to broad-spectrum antimicrobials.