Central venous port-related infection in patients with malignant tumors: An observational study

Akahane, Akio; Sone, Miyuki; Ehara, Shigeru; Kato, Kenichi; Suzuki, Michiko; Tanaka, Ryoichi; Suwabe, Akira; Itabashi, Tetsuya; Kashiwaba, Masahiro

doi:10.3109/03009734.2012.664178

Cited by 7 publications

(9 citation statements)

References 31 publications

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“…The most common infections in this cohort were BSIs. The treatment failure rate was lower for tunnel/pocket infection than for BSI, as was the mortality rate, which was expected because pocket/tunnel infection is a localized infection that usually resolves after the focus (the LTCVC) has been removed (14).…”

Section: Discussionmentioning

confidence: 91%

Role of Lock Therapy for Long-Term Catheter-Related Infections by Multidrug-Resistant Bacteria

Freire

Pierrotti

Zerati

et al. 2018

Antimicrob Agents Chemother

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The management of long-term central venous catheter (LTCVC) infections by multidrug-resistant (MDR) bacteria in cancer patient is a challenge. The objectives of this study were to analyze outcomes in cancer patients with LTCVC-associated infection, identify risks for unfavorable outcomes, and determine the impact of MDR bacteria and antibiotic lock therapy (ALT) in managing such infections. We evaluated all LTCVC-associated infections treated between January 2009 and December 2016. Infections were reported in accordance with international guidelines for catheter-related infections. The outcome measures were 30-day mortality and treatment failure. We analyzed risk factors by Cox forward-stepwise regression. We identified 296 LTCVC-associated infections; 212 (71.6%) were classified as bloodstream infections (BSIs). The most common agent was Forty-six (21.7%) infections were due to MDR Gram-negative bacteria. ALT was used in 62 (29.2%) patients, with a 75.9% success rate. Risk factors identified for failure of the initial treatment were having a high sequential organ failure assessment (SOFA) score at diagnosis of infection and being in palliative care; introduction of ALT at the start of treatment was identified as a protective factor. Risk factors identified for 30-day mortality after LTCVC-associated infection were a high SOFA score at diagnosis, infection with MDR bacteria, and palliative care; introduction of ALT at the start of treatment, hematological malignancies, and adherence to an institutional protocol for the management of LTCVC-associated infection were identified as protective factors. Despite the high incidence of infection with MDR bacteria, ALT improves the outcome of LTCVC-associated infection in cancer patients.

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Section: Discussionmentioning

confidence: 91%

Role of Lock Therapy for Long-Term Catheter-Related Infections by Multidrug-Resistant Bacteria

Freire

Pierrotti

Zerati

et al. 2018

Antimicrob Agents Chemother

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“…e desired location for placement of the catheter tips of the implanted TIP and PICC is the same as that of a CICC [3,9,10,16], implying they are reasonable alternatives for measuring CVP.…”

Section: Discussionmentioning

confidence: 99%

Totally Implanted Port May Be an Alternative to Centrally Inserted Central Catheter for Measurement of Central Venous Pressure

Kuo

Huang

et al. 2020

Journal of Healthcare Engineering

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Background. A conventional centrally inserted central catheter (CICC) is frequently used to measure central venous pressure (CVP) to monitor the cardiocirculatory status of patients. The tip of the totally implanted port (TIP) is inserted at the same location in the superior vena cava as that of a CICC, and the TIP has been implanted in many patients with cancer. Measurements of CVP using CICC (CICCP) and TIP (TIPP) may be closely related. Material and Methods. Ten patients with TIPs in an intensive care unit were prospectively studied, and 121 records of 4536 paired CICCP and TIPP measurements were collected. A bench test in a static or dynamic setting was performed, and 598 paired measurements taken using CICC and TIP were recorded. Results. The measurement of TIPP was highly correlated with that of CICCP in patients with cancer, especially those in a calm state. Patients with a calm state and ≥3 consecutive identical TIPP were recorded (≥30 seconds), and 90% of the mean difference between CICCP and TIPP was ≤2 mmHg. The pressure measurements recorded using CICC and TIP were identical in both the static and dynamic bench tests. Conclusions. TIP may be an alternative to CICC for measuring CVP.

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“…The central venous port has grown in importance in cancer centers because of its advantages over central venous catheters, including the reduction of contamination of the device by external or skin pathogens, with an incidence of port‐related infection that varies between 0.9% and 5.4% . Compared with the incidence of CLABSI for tunneled lines (hazard ratio, 1.77; P ≤ .011), nontunneled central venous catheters have a higher incidence of infection (hazard ratio, 3.50; P < .0001), with the exception of peripherally inserted central catheters, in which the incidence rate of infection has been low, between 0.5 and 0.95 per 1000 catheter‐days …”

Section: Preventing Infectionmentioning

confidence: 99%

Update on infection control practices in cancer hospitals

Ariza-Heredia

Chemaly

2018

CA A Cancer J Clinicians

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Therapies in oncology have evolved rapidly over the last years. At the same pace, supportive care for patients receiving cancer therapy has also evolved, allowing patients to safely receive the newest advances in treatment in both an inpatient and outpatient basis. The recognition of the role of infection control and prevention (ICP) in the outcomes of patients living with cancer has been such that it is now a requirement for hospitals and involves multidisciplinary groups. Some unique aspects of ICP for patients with cancer that have gained momentum over the past few decades include catheter-related infections, multidrug-resistant organisms, community-acquired viral infections, and the impact of the health care environment on the horizontal transmission of organisms. Furthermore, as the potential for infections to cross international borders has increased, alertness for outbreaks or new infections that occur outside the area have become constant. As the future approaches, ICP in immunocompromised hosts will continue to integrate emerging disciplines, such as antibiotic stewardship and the microbiome, and new techniques for environmental cleaning and for controlling the spread of infections, such as whole-genome sequencing. CA Cancer J Clin 2018;000:000-000. © 2018 American Cancer Society.

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Central venous port-related infection in patients with malignant tumors: An observational study

Cited by 7 publications

References 31 publications

Role of Lock Therapy for Long-Term Catheter-Related Infections by Multidrug-Resistant Bacteria

Role of Lock Therapy for Long-Term Catheter-Related Infections by Multidrug-Resistant Bacteria

Totally Implanted Port May Be an Alternative to Centrally Inserted Central Catheter for Measurement of Central Venous Pressure

Update on infection control practices in cancer hospitals

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