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Central line-associated bloodstream infections (CLABSIs) are a significant healthcare challenge globally, increasing mortality risk and complicating central vascular catheter use. 1 CLABSI is defined as a primary bloodstream infection (BSI) in a patient that had a central line within the 48-hour period before the development of the BSI and is not bloodstream-related to an infection at another site.2 These central venous devices are crucial in the diagnosis and management of numerous paediatric conditions; however, their use is associated with the risk of central line-associated bloodstream infection (CLABSI).3 We aimed to analyse the distribution of CLABSI episodes, the time to antibiotic administration, fever episodes, non CLABSI diagnosis, and the microbiological organisms associated with the infections. Additionally, the impact of different screening protocols on CLABSI management and outcomes is examined.This study investigates the epidemiology and management of CLABSI in a cohort of 37 patients on home parenteral nutrition over the past 2 years. Data was collected on age, diagnosis, how many times a week their lines are accessed, episode of fever, causative microorganisms, screening and time to antibiotics for CLABSI episodes.26/37 patients (70%) presented with fever at least once during the study period. Age at presentation ranged from 1 – 16. Diagnoses included surgical short bowel syndrome, enteropathy, chronic intestinal pseudo-obstruction, trichohepatoenteric syndrome, cystic fibrosis, DGAT Mutation, MYO5B gene mutation and small bowel sclerosis.There were 102 episodes of fever, median of n=2 per patient. 22/102 (21.5%) being due to CLABSI. 15.7% had another diagnosis like viral URTI (Rhinovirus (n=7) and Influenza (n=5) were most common) UTI, viral enteritis, and 62.75% with no causative organism isolated.A small proportion (n=4) of patients experienced multiple episodes of CLABSI, with the highest number of episodes being four in a single case.Enterococcus faecium (n=4 was the most frequently isolated pathogen from central line culture, followed by Staphylococcus epidermidis (n=3), Staphylococcus aureus (n=3), and Candida (n=3). Time from decision to give to administration of antibiotics was collected for the 22 episodes of CLABSI. 11/22 (50%) received antibiotics within 0–1 hour of decision, while 8/22 (36.36%) received antibiotics within 1–2 hours, and 3(13.64%) received antibiotics >3 hours after the decision to start antibiotics was made.The majority of fevers in our CVC patient population were not associated with CLABSI. The majority of CLABSI cases were single episodes, but a small proportion of patients experienced recurrent CLABSI. All cases of suspected CLABSI should receive IV antibiotics within 1 hour of decision to treat; barriers to this are under review. Candida species has been implicated (n=4, 18% of CLABSI), a high index of suspicion should be maintained for this.References Mario J, Karim J, Barrera L, Liscano Y. Impact of central line-associated bloodstream infections on mortality and hospital stay in adult patients at a tertiary care institution in Cali, Colombia, 2015–2018. Journal of Clinical Medicine 2024 Sep 11;13(18):5376–6.Alshahrani KM, Alhuwaishel AZ, Alangari NM, Asiri MA, Al-Shahrani NA, Alasmari AA, et al. Clinical impacts and risk factors for central line-associated bloodstream infection: a systematic review. Cureus [Internet]. 2023 Jun 25;15(6). Available from: https://www.cureus.com/articles/162108-clinical-impacts-and-risk-factors-for-central-line-associated-bloodstream-infection-a-systematic-review#Li L, Zheng Y, Deng W, Chen X, Lin S. Central line-associated bloodstream infections in children: a systematic review and meta-analysis. Translational Pediatrics [Internet]. 2025 May 1 [cited 2025 Jul 7];14(5):799–811. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC12163823/