Totally implantable central venous access port infections: Incidence and risk factors

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Intravenous literature: Touré, A., Vanhems, P., Lombard-Bohas, C., Cassier, P., Péré-Vergé, D., Souquet, J-C., Ecochard, R. and Chambrier, C. (2012) Totally implantable

central venous access port infections in patients with digestive cancer: Incidence and risk factors. AJIC: American Journal of Infection Control. 40(10), p.935-939.

Abstract:

Background – Central venous access port–related bloodstream infection (CVAP-BSI) is associated with morbidity and mortality in patients with cancer. This study examined the incidence rates and risk factors for CVAP-BSI in adult patients with digestive cancer.

Methods – This prospective observational cohort study was performed from 2007 to 2011 in 2 oncology units of a university hospital. Incidence rate was expressed as number of CVAP-BSI per 1,000 catheter-days. A Cox regression model was used to identify risk factors for CVAP-BSI.

Results – A total of 315 patients were included. CVAP-BSI occurred in 41 patients (13.0%). The overall incidence rate was 0.76/1,000 catheter-days. The rate was higher in patients with esophageal cancer (1.28. P = .05) and pancreatic cancer (1.24; P = .007). Risk factors independently associated with CVAP-BSI were World Health Organization performance status between 2 and 4, catheter utilization-days in the previous month, pancreatic cancer, and parenteral nutrition. Coagulase-negative Staphylococci and enterobacteria were the main microorganisms isolated.

Conclusions – In adult patients with digestive cancer, pancreatic cancer, cumulative catheter utilization-days, World Health Organization performance status, and parenteral nutrition were identified as independent risk factors for CVAP-BSI. Patients with any of these risk factors could be candidates for preventive strategies.

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