Defining Bloodstream Infections Related to Central Venous Catheters in Patients With Cancer: A Systematic Review

Abstract

The objective of this review was to determine whether consistent definitions were used in published studies of bloodstream infections due to central venous catheters in patients with cancer (ie, catheter-related or catheter-associated bloodstream infections). Review of 191 studies reporting catheter-related or catheter-associated bloodstream infections in patients with cancer revealed a lack of uniformity in these definitions. We grouped definitions by type, with 39 articles failing to cite or report a definition. Definitions included those of the Centers for Disease Control and Prevention (n = 39) and the Infectious Diseases Society of America (n = 18). The criteria included in the definitions in studies were also tabulated. Clinical manifestations were frequently included. Definitions used have been highly variable; comparability of risk factors, incidence, management, and outcomes of such infections is difficult to achieve across studies. Future research should focus on development of a common definition of catheter-related and catheter-associated bloodstream infections for both adults and children with cancer.

Incidence of Central Venous Catheter-Related Infection and Risk Factors in Critically Ill Post-Operative Cancer Patients: A Randomized Prospective Cohort Study

“…were the most common cause of CRBSI in our study, similar to the studies of Schiffer (3) and Hentrich (26). 4 Arch Crit Care Med. 2016; 1(4):e7732.…”

“…In general, patients with cancer have 1.4 to 2.2 infections per 1000 catheter-days for central venous catheters (CVCs) (3). Catheter-related bloodstream infections cause serious morbidity and mortality and are associated with increased hospital costs and length of stay (4,5). Attributable rate of mortality is 0% to 35%, based on the degree of control for severity of illness (1).…”

“…Infec-tious complications with Teflon or polyurethane catheters are less than catheters made of polyvinyl chloride or polyethylene (7,8). Cancer patients are immunocompromised and, hence, susceptive to infection (4,9). Infection process in cancer patients is on the quiet and its manifestations are irregular (10,11).…”

Diagnosis of Aortic Graft Infection: A Case Definition by the Management of Aortic Graft Infection Collaboration (MAGIC)

“…Further validation of these criteria is needed but in particular it is worth noting that the Centers for Disease Control central venous device infection definition also entails a similar process of eliminating alternative sources for positive blood cultures. 33 Moreover it has also been proposed that any bacteremia, irrespective of source and within 4 weeks of graft implantation, should automatically be regarded with suspicion owing to the likelihood of hematogenous "seeding" to the prosthetic luminal surface before endothelial coverage is presumed to have occurred. 5 Notwithstanding significant deficiencies in the published evidence and in order to define a necessary time point "cutoff", the recommendation that AGI should be strongly suspected if CT demonstrates perigraft fluid at 3 months post-graft insertion was considered reasonable and consistent with clinical experience.…”

Expert Consensus for Multimodality Imaging Evaluation of Adult Patients during and after Cancer Therapy: A Report from the American Society of Echocardiography and the European Association of Cardiovascular Imaging

“…mitral valve prolapse 55 and bicuspid aortic valve) or with indwelling central venous catheters placed for vascular access. 64 Valve disease may occur as a consequence of CTRCD. This usually manifests as mitral regurgitation caused by annular dilation or apical tethering in the setting of LV dysfunction and secondary LV remodelling.…”