1857. Risk factors for recurrent bacteremia in children undergoing chemotherapy or hematopoietic stem cell transplantation

Abstract Background Sepsis is a complication frequently encountered in children with underlying malignancies, especially due to majority of patients having indwelling venous catheters. Indications for catheter removal among central-line associated blood stream infection (CLABSI) should follow the recommendations adults, however, difficulties vascular access often leads attempting treatment without removal. Therefore, primary aim this study was find risk factors recurrent sepsis undergoing chemotherapy HSCT and examine whether more aggressive after CLABSI necessary. Methods In Pediatric Bone Marrow Transplant Center Seoul St. Mary’s Hospital, positive cultures were prospectively monitored control prevent outbreaks. The date culture, culture results, symptoms presented, category infections (by CDC/NHSN surveillance definition (2021) Bloodstream infections), events monitored. Results During September 2016 February 2021, total 280 cases laboratory confirmed bloodstream (LCBI) or Mucosal Barrier Injury LCBI (MBI-LCBI) diagnosed < 18 years old malignancies. Of these, 52.9% (n=148) male, mean age 9.7 (SD±6.1) old. 51.8% (n=145), most common pathogens cultured S. mitis/oralis (24.0%, n=67), E. coli (15.4%, n=43), coagulase negative Staphylococci (CNS) (10.4%, n=29). Recurrent occured 17.1% (n=48), 9.6% (n=27) had two catheters . Multivariable analysis showed that as follows: duration (OR, 1.002; 95% CI, 1.001-1.004; P< 0.001) no central lines previous episode 51.143; 6.6-395.0; 0.001). Conclusion Permanent be removed soon possible, approach permanent LCBSIs necessary reduce infections. Disclosures All Authors: No reported disclosures.