A Case-Control Study to Identify Risk Factors for Totally Implantable Central Venous Port-Related Bloodstream Infection.
- Author:
Guk Jin LEE
1
;
Sook Hee HONG
;
Sang Young ROH
;
Sa Rah PARK
;
Myung Ah LEE
;
Hoo Geun CHUN
;
Young Seon HONG
;
Jin Hyoung KANG
;
Sang Il KIM
;
Youn Jeong KIM
;
Ho Jong CHUN
;
Jung Suk OH
Author Information
1. Division of Medical Oncology, Department of Internal Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea. jinkang@catholic.ac.kr
- Publication Type:Original Article
- Keywords:
Neoplasms;
Catheter-related infections;
Risk factors
- MeSH:
Case-Control Studies*;
Catheter-Related Infections;
Catheters;
Drug Therapy;
Fungi;
Gastrointestinal Neoplasms;
Gram-Positive Cocci;
Humans;
Mortality;
Multivariate Analysis;
Risk Factors*
- From:Cancer Research and Treatment
2014;46(3):250-260
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: To date, the risk factors for central venous port-related bloodstream infection (CVP-BSI) in solid cancer patients have not been fully elucidated. We conducted this study in order to determine the risk factors for CVP-BSI in patients with solid cancer. MATERIALS AND METHODS: A total of 1,642 patients with solid cancer received an implantable central venous port for delivery of chemotherapy between October 2008 and December 2011 in a single center. CVP-BSI was diagnosed in 66 patients (4%). We selected a control group of 130 patients, who were individually matched with respect to age, sex, and catheter insertion time. RESULTS: CVP-BSI occurred most frequently between September and November (37.9%). The most common pathogen was gram-positive cocci (n=35, 53.0%), followed by fungus (n=14, 21.2%). Multivariate analysis identified monthly catheter-stay as a risk factor for CVP-BSI (p=0.000), however, its risk was lower in primary gastrointestinal cancer than in other cancer (p=0.002). Initial metastatic disease and long catheter-stay were statistically significant factors affecting catheter life span (p=0.005 and p=0.000). Results of multivariate analysis showed that recent transfusion was a risk factor for mortality in patients with CVP-BSI (p=0.047). CONCLUSION: In analysis of the results with respect to risk factors, prolonged catheter-stay should be avoided as much as possible. It is necessary to be cautious of CVP-BSI in metastatic solid cancer, especially non-gastrointestinal cancer. In addition, avoidance of unnecessary transfusion is essential in order to reduce the mortality of CVP-BSI. Finally, considering the fact that confounding factors may have affected the results, conduct of a well-designed prospective controlled study is warranted.
