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Advances in the Diagnosis and Management of Central Venous Access Device Infections in Children

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Hot Topics in Infection and Immunity in Children VII

Part of the book series: Advances in Experimental Medicine and Biology ((AEMB,volume 697))

Abstract

Infection is a well-known complication of central venous access device (CVAD) use, with an incidence of 3–6 bloodstream infections per 1,000 catheter days in children. Prevention of CVAD infections has improved with new strategies including the use of chlorhexidine antisepsis, bundles, maximal sterile barriers for insertion, prophylactic locks, antibiotic impregnated catheters and tunnelling of long-term devices. Despite these strategies, catheter-related bloodstream infections (CRBSIs) continue to be an important health problem. New approaches to diagnosis include differential time to positivity and quantification of blood cultures and molecular diagnostics. The management of CRBSIs includes techniques for line salvage including ethanol, antibiotic, hydrochloric acid, taurolidine and urokinase locks. When these fail, line removal and antimicrobial therapy are recommended.

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References

  1. Garcia-Teresa MA, Casado-Flores J, Delgado Dominguez MA, Roqueta-Mas J, Cambra-Lasaosa F, Concha-Torre A et al. Infectious complications of percutaneous central venous catheterization in pediatric patients: a Spanish multicenter study. Intensive Care Med. 2007 Mar;33(3):466–76.

    Article  PubMed  Google Scholar 

  2. Pittet D, Tarara D, Wenzel RP. Nosocomial bloodstream infection in critically ill patients. Excess length of stay, extra costs, and attributable mortality. JAMA. 1994 May 25;271(20):1598–601.

    Article  CAS  PubMed  Google Scholar 

  3. Smith MJ. Catheter related blood stream infections in children. Am J Infect Control. 2008; http://www.ajic.org.

  4. McGee DC, Gould MK. Preventing complications of central venous catheterization. N Engl J Med. 2003 Mar 20;348(12):1123–33.

    Article  PubMed  Google Scholar 

  5. Abdul-Rauf A, Gauderer M, Chiarucci K, Berman B. Long-term central venous access in patients with sickle cell disease. Incidence of thrombotic and infectious complications. J Pediatr Hematol Oncol. 1995 Nov;17(4):342–5.

    Article  CAS  PubMed  Google Scholar 

  6. Tarantino MD, Lail A, Donfield SM, Lynn H, Peddle L, Hunsberger S et al. Surveillance of infectious complications associated with central venous access devices in children with haemophilia. Haemophilia. 2003 Sep;9(5):588–92.

    Article  CAS  PubMed  Google Scholar 

  7. Tobiansky R, Lui K, Dalton DM, Shaw P, Martin H, Isaacs D. Complications of central venous access devices in children with and without cancer. J Paediatr Child Health. 1997 Dec;33(6):509–14.

    Article  CAS  PubMed  Google Scholar 

  8. Dezfulian C, Lavelle J, Nallamothu BK, Kaufman SR, Saint S. Rates of infection for single-lumen versus multilumen central venous catheters: a meta-analysis. Crit Care Med. 2003 Sep;31(9):2385–90.

    Article  PubMed  Google Scholar 

  9. Broviac JW, Cole JJ, Scribner BH. A silicone rubber atrial catheter for prolonged parenteral alimentation. Surg Gynecol Obstet. 1973 Apr;136(4):602–6.

    CAS  PubMed  Google Scholar 

  10. Murai DT. Are femoral Broviac catheters effective and safe? A prospective comparison of femoral and jugular venous broviac catheters in newborn infants. Chest 2002 May;121(5):1527–30.

    Article  PubMed  Google Scholar 

  11. Bouza E, Burillo A, Munoz P. Catheter-related infections: diagnosis and intravascular treatment. Clin Microbiol Infect. 2002 May;8(5):265–74.

    Article  CAS  PubMed  Google Scholar 

  12. Donlan RM. Biofilm formation: a clinically relevant microbiological process. Clin Infect Dis. 2001 Oct 15;33(8):1387–92.

    Article  CAS  PubMed  Google Scholar 

  13. Donlan RM, Costerton JW. Biofilms: survival mechanisms of clinically relevant microorganisms. Clin Microbiol Rev. 2002 Apr;15(2):167–93.

    Article  CAS  PubMed  Google Scholar 

  14. Ceri H, Olson ME, Stremick C, Read RR, Morck D, Buret A. The Calgary Biofilm Device: new technology for rapid determination of antibiotic susceptibilities of bacterial biofilms. J Clin Microbiol. 1999 June;37(6):1771–6.

    CAS  PubMed  Google Scholar 

  15. Curtin J, Cormican M, Fleming G, Keelehan J, Colleran E. Linezolid compared with eperezolid, vancomycin, and gentamicin in an in vitro model of antimicrobial lock therapy for Staphylococcus epidermidis central venous catheter-related biofilm infections. Antimicrob Agents Chemother. 2003 Oct;47(10):3145–8.

    Article  CAS  PubMed  Google Scholar 

  16. Wisplinghoff H, Seifert H, Tallent SM, Bischoff T, Wenzel RP, Edmond MB. Nosocomial bloodstream infections in pediatric patients in United States hospitals: epidemiology, clinical features and susceptibilities. Pediatr Infect Dis J. 2003 Aug;22(8):686–91.

    Google Scholar 

  17. Rijnders BJ, Van WE, Vandecasteele SJ, Stas M, Peetermans WE. Treatment of long-term intravascular catheter-related bacteraemia with antibiotic lock: randomized, placebo-controlled trial. J Antimicrob Chemother. 2005 Jan;55(1):90–4.

    Article  CAS  PubMed  Google Scholar 

  18. O’Grady NP, Alexander M, Dellinger EP, Gerberding JL, Heard SO, Maki DG et al. Guidelines for the prevention of intravascular catheter-related infections. The Hospital Infection Control Practices Advisory Committee, Center for Disease Control and Prevention. US Pediatr. 2002 Nov;110(5):e51.

    Article  Google Scholar 

  19. Raad I, Hanna H, Maki D. Intravascular catheter-related infections: advances in diagnosis, prevention, and management. Lancet Infect Dis. 2007 Oct;7(10):645–57.

    Article  PubMed  Google Scholar 

  20. Safdar N, Kluger DM, Maki DG. A review of risk factors for catheter-related bloodstream infection caused by percutaneously inserted, noncuffed central venous catheters: implications for preventive strategies. Medicine (Baltimore). 2002 Nov;81(6):466–79.

    Article  Google Scholar 

  21. Sohn AH, Garrett DO, Sinkowitz-Cochran RL, Grohskopf LA, Levine GL, Stover BH et al. Prevalence of nosocomial infections in neonatal intensive care unit patients: Results from the first national point-prevalence survey. J Pediatr. 2001 Dec;139(6):821–7.

    Article  CAS  PubMed  Google Scholar 

  22. Randolph AG, Brun-Buisson C, Goldmann D. Identification of central venous catheter-related infections in infants and children. Pediatr Crit Care Med. 2005 May;6(3 Suppl):S19–S24.

    Article  PubMed  Google Scholar 

  23. Odetola FO, Moler FW, Dechert RE, VanDerElzen K, Chenoweth C. Nosocomial catheter-related bloodstream infections in a pediatric intensive care unit: risk and rates associated with various intravascular technologies. Pediatr Crit Care Med. 2003 Oct;4(4):432–6.

    Article  PubMed  Google Scholar 

  24. Adler A, Yaniv I, Solter E, Freud E, Samra Z, Stein J et al. Catheter-associated bloodstream infections in pediatric hematology-oncology patients: factors associated with catheter removal and recurrence. J Pediatr Hematol Oncol. 2006 Jan;28(1):23–8.

    PubMed  Google Scholar 

  25. Simon A, Bode U, Beutel K. Diagnosis and treatment of catheter-related infections in paediatric oncology: an update. Clin Microbiol Infect. 2006 July;12(7):606–20.

    Article  CAS  PubMed  Google Scholar 

  26. Colomb V, Fabeiro M, Dabbas M, Goulet O, Merckx J, Ricour C. Central venous catheter-related infections in children on long-term home parenteral nutrition: incidence and risk factors. Clin Nutr. 2000 Oct;19(5):355–9.

    Article  CAS  PubMed  Google Scholar 

  27. Beghetto MG, Victorino J, Teixeira L, de Azevedo MJ. Parenteral nutrition as a risk factor for central venous catheter-related infection. JPEN J Parenter Enteral Nutr. 2005 Sep;29(5):367–73.

    Article  PubMed  Google Scholar 

  28. Goldstein SL, Macierowski CT, Jabs K. Hemodialysis catheter survival and complications in children and adolescents. Pediatr Nephrol. 1997 Feb;11(1):74–7.

    Article  CAS  PubMed  Google Scholar 

  29. Paglialonga F, Esposito S, Edefonti A, Principi N. Catheter-related infections in children treated with hemodialysis. Pediatr Nephrol. 2004 Dec;19(12):1324–33.

    Article  PubMed  Google Scholar 

  30. Maki DG, Kluger DM, Crnich CJ. The risk of bloodstream infection in adults with different intravascular devices: a systematic review of 200 published prospective studies. Mayo Clin Proc. 2006 Sep;81(9):1159–71.

    Article  PubMed  Google Scholar 

  31. Randolph AG, Cook DJ, Gonzales CA, Brun-Buisson C. Tunneling short-term central venous catheters to prevent catheter-related infection: a meta-analysis of randomized, controlled trials. Crit Care Med. 1998 Aug;26(8):1452–7.

    Article  CAS  PubMed  Google Scholar 

  32. Nahum E, Levy I, Katz J, Samra Z, Ashkenazi S, Ben-Ari J et al. Efficacy of subcutaneous tunneling for prevention of bacterial colonization of femoral central venous catheters in critically ill children. Pediatr Infect Dis J. 2002 Nov;21(11):1000–4.

    Article  PubMed  Google Scholar 

  33. Kline AM. Pediatric catheter-related bloodstream infections: latest strategies to decrease risk. AACN Clin Issues. 2005 Apr;16(2):185–98.

    Article  PubMed  Google Scholar 

  34. Mermel LA, Farr BM, Sherertz RJ, Raad II, O’Grady N, Harris JS et al. Guidelines for the management of intravascular catheter-related infections. Clin Infect Dis. 2001 May 1;32(9):1249–72.

    Article  CAS  PubMed  Google Scholar 

  35. Flynn PM, Shenep JL, Stokes DC, Barrett FF. In situ management of confirmed central venous catheter-related bacteremia. Pediatr Infect Dis J. 1987 Aug;6(8):729–34.

    Article  CAS  PubMed  Google Scholar 

  36. Abdelkefi A, Achour W, Torjman L, Ben OT, Ladeb S, Lakhal A et al. Detection of catheter-related bloodstream infections by the Gram stain-acridine orange leukocyte cytospin test in hematopoietic stem cell transplant recipients. Bone Marrow Transplant. 2006 Mar;37(6):595–9.

    Article  CAS  PubMed  Google Scholar 

  37. Widmer AF, Nettleman M, Flint K, Wenzel RP. The clinical impact of culturing central venous catheters. A prospective study. Arch Intern Med. 1992 Jun;152(6):1299–302.

    CAS  Google Scholar 

  38. Farina C, Bonanomi E, Benetti G, Fumagalli R, Goglio A. Acridine orange leukocyte cytospin test for central venous catheter–related bloodstream infection: a pediatric experience. Diagn Microbiol Infect Dis. 2005 Aug;52(4):337–9.

    Article  PubMed  Google Scholar 

  39. Millar MR, Johnson G, Wilks M, Skinner R, Stoneham S, Pizer B et al. Molecular diagnosis of vascular access device-associated infection in children being treated for cancer or leukaemia. Clin Microbiol Infect. 2008 Mar;14(3):213–20.

    Article  CAS  PubMed  Google Scholar 

  40. Abdelkefi A, Achour W, Ben OT, Torjman L, Ladeb S, Lakhal A et al. Difference in time to positivity is useful for the diagnosis of catheter-related bloodstream infection in hematopoietic stem cell transplant recipients. Bone Marrow Transplant. 2005 Feb;35(4):397–401.

    Article  CAS  PubMed  Google Scholar 

  41. Acuna M, O’Ryan M, Cofre J, Alvarez I, Benadof D, Rodriguez P et al. Differential time to positivity and quantitative cultures for noninvasive diagnosis of catheter-related blood stream infection in children. Pediatr Infect Dis J. 2008 Aug;27(8):681–5.

    Article  PubMed  Google Scholar 

  42. Flynn PM, Shenep JL, Barrett FF. Differential quantitation with a commercial blood culture tube for diagnosis of catheter-related infection. J Clin Microbiol. 1988 May;26(5):1045–6.

    CAS  PubMed  Google Scholar 

  43. Gaur AH, Flynn PM, Giannini MA, Shenep JL, Hayden RT. Difference in time to detection: a simple method to differentiate catheter-related from non-catheter-related bloodstream infection in immunocompromised pediatric patients. Clin Infect Dis. 2003 Aug 15;37(4):469–75.

    Google Scholar 

  44. Germanakis I, Christidou A, Galanakis E, Kyriakakis I, Tselentis Y, Kalmanti M. Qualitative versus quantitative blood cultures in the diagnosis of catheter-related bloodstream infections in children with malignancy. Pediatr Blood Cancer. 2005 Dec;45(7):939–44.

    Article  PubMed  Google Scholar 

  45. Germanakis J, Stiakaki E, Galanakis E, Christidou A, Neonakis J, Dimitriou H et al. Prognostic value of quantitative blood cultures for the outcome of central venous catheters in children. Scand J Infect Dis. 2002;34(9):680–2.

    Article  PubMed  Google Scholar 

  46. Guerti K, Ieven M, Mahieu L. Diagnosis of catheter-related bloodstream infection in neonates: a study on the value of differential time to positivity of paired blood cultures. Pediatr Crit Care Med. 2007 Sep;8(5):470–5.

    Article  PubMed  Google Scholar 

  47. O’Grady NP, Alexander M, Dellinger EP, Gerberding JL, Heard SO, Maki DG et al. Guidelines for the prevention of intravascular catheter-related infections. Centers for disease control and prevention. MMWR Recomm Rep. 2002 Aug 9;51(RR-10):1–29.

    Google Scholar 

  48. Crnich CJ, Maki DG. The promise of novel technology for the prevention of intravascular device-related bloodstream infection. II. Long-term devices. Clin Infect Dis. 2002 May 15;34(10):1362–8.

    Article  PubMed  Google Scholar 

  49. Crnich CJ, Maki DG. The promise of novel technology for the prevention of intravascular device-related bloodstream infection. I. Pathogenesis and short-term devices. Clin Infect Dis. 2002 May 1;34(9):1232–42.

    Article  PubMed  Google Scholar 

  50. Veenstra DL, Saint S, Sullivan SD. Cost-effectiveness of antiseptic-impregnated central venous catheters for the prevention of catheter-related bloodstream infection. JAMA. 1999 Aug 11;282(6):554–60.

    Article  CAS  PubMed  Google Scholar 

  51. Oncu S, Oncu S, Ozturk B, Kurt I, Sakarya S. Elimination of intraluminal colonization by antibiotic lock in catheters. Tohoku J Exp Med. 2004 May;203(1):1–8.

    Article  CAS  PubMed  Google Scholar 

  52. Carratala J. The antibiotic-lock technique for therapy of ‘highly needed’ infected catheters. Clin Microbiol Infect. 2002 May;8(5):282–9.

    Article  CAS  PubMed  Google Scholar 

  53. Lee JY, Ko KS, Peck KR, Oh WS, Song JH. In vitro evaluation of the antibiotic lock technique (ALT) for the treatment of catheter-related infections caused by staphylococci. J Antimicrob Chemother. 2006 Jun;57(6):1110–15.

    Article  CAS  PubMed  Google Scholar 

  54. Lee MY, Ko KS, Song JH, Peck KR. In vitro effectiveness of the antibiotic lock technique (ALT) for the treatment of catheter-related infections by Pseudomonas aeruginosa and Klebsiella pneumoniae. J Antimicrob Chemother. 2007 Oct;60(4):782–7.

    Article  CAS  PubMed  Google Scholar 

  55. Raad I, Hanna H, Jiang Y, Dvorak T, Reitzel R, Chaiban G et al. Comparative activities of daptomycin, linezolid, and tigecycline against catheter-related methicillin-resistant Staphylococcus bacteremic isolates embedded in biofilm. Antimicrob Agents Chemother. 2007 May;51(5):1656–60.

    Article  CAS  PubMed  Google Scholar 

  56. Bestul MB, Vandenbussche HL. Antibiotic lock technique: review of the literature. Pharmacotherapy. 2005 Feb;25(2):211–27.

    Article  CAS  PubMed  Google Scholar 

  57. Segarra-Newnham M, Martin-Cooper EM. Antibiotic lock technique: a review of the literature. Ann Pharmacother. 2005 Feb;39(2):311–18.

    Article  PubMed  Google Scholar 

  58. Castagnola E, Moroni C, Gandullia P, Oddone M, Peri C, Casciaro R et al. Catheter lock and systemic infusion of linezolid for treatment of persistent Broviac catheter-related staphylococcal bacteremia. Antimicrob Agents Chemother. 2006 Mar;50(3):1120–1.

    Article  CAS  PubMed  Google Scholar 

  59. Fernandez-Hidalgo N, Almirante B, Calleja R, Ruiz I, Planes AM, Rodriguez D et al. Antibiotic-lock therapy for long-term intravascular catheter-related bacteraemia: results of an open, non-comparative study. J Antimicrob Chemother. 2006 Jun;57(6):1172–80.

    Article  CAS  PubMed  Google Scholar 

  60. Guedon C, Nouvellon M, Lalaude O, Lerebours E. Efficacy of antibiotic-lock technique with teicoplanin in staphylococcus epidermidis catheter-related sepsis during long-term parenteral nutrition. JPEN J Parenter Enteral Nutr. 2002 Mar;26(2):109–13.

    Article  CAS  PubMed  Google Scholar 

  61. Viale P, Pagani L, Petrosillo N, Signorini L, Colombini P, Macri G et al. Antibiotic lock-technique for the treatment of catheter-related bloodstream infections. J Chemother. 2003 Apr;15(2):152–6.

    CAS  PubMed  Google Scholar 

  62. Safdar N, Maki DG. Use of vancomycin-containing lock or flush solutions for prevention of bloodstream infection associated with central venous access devices: a meta-analysis of prospective, randomized trials. Clin Infect Dis. 2006 Aug 15;43(4):474–84.

    Article  PubMed  Google Scholar 

  63. Cuntz D, Michaud L, Guimber D, Husson MO, Gottrand F, Turck D. Local antibiotic lock for the treatment of infections related to central catheters in parenteral nutrition in children. JPEN J Parenter Enteral Nutr. 2002 Mar;26(2):104–8.

    Article  CAS  PubMed  Google Scholar 

  64. Johnson DC, Johnson FL, Goldman S. Preliminary results treating persistent central venous catheter infections with the antibiotic lock technique in pediatric patients. Pediatr Infect Dis J. 1994 Oct;13(10):930–1.

    Article  CAS  PubMed  Google Scholar 

  65. Elwood RL, Spencer SE. Successful clearance of catheter-related bloodstream infection by antibiotic lock therapy using ampicillin. Ann Pharmacother. 2006 Feb;40(2):347–50.

    Article  PubMed  Google Scholar 

  66. Garland JS, Alex CP, Henrickson KJ, McAuliffe TL, Maki DG. A vancomycin-heparin lock solution for prevention of nosocomial bloodstream infection in critically ill neonates with peripherally inserted central venous catheters: a prospective, randomized trial. Pediatrics. 2005 Aug;116(2):e198–e205.

    Article  PubMed  Google Scholar 

  67. Chambers ST, Peddie B, Pithie A. Ethanol disinfection of plastic-adherent micro-organisms. J Hosp Infect. 2006 Jun;63(2):193–6.

    Article  CAS  PubMed  Google Scholar 

  68. Dannenberg C, Bierbach U, Rothe A, Beer J, Korholz D. Ethanol-lock technique in the treatment of bloodstream infections in pediatric oncology patients with broviac catheter. J Pediatr Hematol Oncol. 2003 Aug;25(8):616–21.

    Article  PubMed  Google Scholar 

  69. Onland W, Shin CE, Fustar S, Rushing T, Wong WY. Ethanol-lock technique for persistent bacteremia of long-term intravascular devices in pediatric patients. Arch Pediatr Adolesc Med. 2006 Oct;160(10):1049–53.

    Article  PubMed  Google Scholar 

  70. Bowen A, Walls T, Day A, Jackson R, Russell S, Clarkson C, Palasanthiran P. Ethanol lock therapy as adjunctive management of central venous access device infections in total parenteral nutrition dependent children. Poster presented to the Australasian Society of Infectious Diseases conference, New South Wales, 25–29 March 2009.

    Google Scholar 

  71. Barbaric D, Curtin J, Pearson L, Shaw PJ. Role of hydrochloric acid in the treatment of central venous catheter infections in children with cancer. Cancer. 2004 Oct 15;101(8):1866–72.

    Article  CAS  PubMed  Google Scholar 

  72. Bradshaw JH, Puntis JW. Taurolidine and catheter-related bloodstream infection: a systematic review of the literature. J Pediatr Gastroenterol Nutr. 2008 Aug;47(2):179–86.

    Article  PubMed  Google Scholar 

  73. Simon A, Ammann RA, Wiszniewsky G, Bode U, Fleischhack G, Besuden MM. Taurolidine-citrate lock solution (TauroLock) significantly reduces CVAD-associated grampositive infections in pediatric cancer patients. BMC Infect Dis. 2008;8:102.

    Article  PubMed  Google Scholar 

  74. Jones GR, Konsler GK, Dunaway RP. Urokinase in the treatment of bacteremia and candidemia in patients with right atrial catheters. Am J Infect Control. 1996 Jun;24(3):160–6.

    Article  CAS  PubMed  Google Scholar 

  75. Simon A, Bode U, Lieber K, Beutel K, Fleischhack G. Review and update of the use of urokinase in the prevention and management of CVAD-related complications in pediatric oncology patients. Am J Infect Control. 2008 Feb;36(1):54–8.

    Article  PubMed  Google Scholar 

  76. Aquino VM, Sandler ES, Mustafa MM, Steele JW, Buchanan GR. A prospective double-blind randomized trial of urokinase flushes to prevent bacteremia resulting from luminal colonization of subcutaneous central venous catheters. J Pediatr Hematol Oncol. 2002 Dec;24(9):710–13.

    Article  PubMed  Google Scholar 

  77. Dillon PW, Jones GR, Bagnall-Reeb HA, Buckley JD, Wiener ES, Haase GM. Prophylactic urokinase in the management of long-term venous access devices in children: a children’s oncology group study. J Clin Oncol. 2004 Jul 1;22(13):2718–23.

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Paediatric Infectious Diseases, Alice Springs Hospital, Alice Springs, Northern Territory, Australia

    Asha Bowen

  2. Menzies School of Health Research, Darwin, Northern Territory, Australia

    Jonathan Carapetis

  3. Charles Darwin University, Darwin, Northern Territory, Australia

    Jonathan Carapetis

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Correspondence to Jonathan Carapetis .

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Editors and Affiliations

  1. Royal Children's Hospital, Dept. Pediatrics, University of Melbourne, Flemington Road, Parkville, 3052, Victoria, Australia

    Nigel Curtis

  2. Institute of Child Life and Health, UBHT Education Centre, University of Bristol, Upper Maudlin Street, Bristol, BS2 8AE, United Kingdom

    Adam Finn

  3. University of Oxford, Level 4,John Radcliffe Hospital, Oxford, OX3 9DU, United Kingdom

    Andrew J. Pollard

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Bowen, A., Carapetis, J. (2011). Advances in the Diagnosis and Management of Central Venous Access Device Infections in Children. In: Curtis, N., Finn, A., Pollard, A. (eds) Hot Topics in Infection and Immunity in Children VII. Advances in Experimental Medicine and Biology, vol 697. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-7185-2_8

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