Skip to main content

Risk Factors of Infection and Role of Antibiotic Prophylaxis in Totally Implantable Venous Access Port Placement: Propensity Score Matching



To evaluate risk factors of infection and effectiveness of preprocedural single-dose intravenous prophylactic antibiotic (PABX) during totally implantable venous access port (TIVAP) placement in preventing procedure-related infections.


This was a retrospective single-institution multicenter study evaluating short-term (30-day) infection outcomes after TIVAP placement. Correlation between infection rates and clinical factors, including hematologic versus non-hematologic malignancy, inpatient versus outpatient status, single versus double lumen and PABX, was investigated using univariate and multivariable analysis in the overall study population as well as the propensity-score-matched cohort.


Overall, 5967 patients underwent TIVAP placement from 2005 to 2016, of which 3978 (67%) patients received PABX. On propensity score matching, 1952 patients with PABX were matched to the same number of patients without PABX. TIVAP was removed due to infection concern in 48 patients in unmatched and 30 patients in matched population. There was no difference in the rate of infection between those who received PABX and those who did not in both unmatched and matched population (p = 0.5387 and 0.9999). Although infection rate was significantly higher in patients who had TIVAP placement in inpatient setting (p < 0.0001), who received a double-lumen TIVAP (p < 0.0001), or who had hematologic malignancy (p = 0.0004) on univariate analysis, inpatient status was the sole factor associated with higher rate of TIVAP infection on multivariable analysis of both overall (odds ratio 2.31, p < 0.0001) and matched populations (odds ratio 4.36, p = 0.0004).


Placement of TIVAP in inpatient setting increases the risk of TIVAP infection. PABX before TIVAP placement does not prevent short-term procedure-related infections.

This is a preview of subscription content, access via your institution.

Fig. 1
Fig. 2


  1. 1.

    Stocco JG, Hoers H, Pott FS, Crozeta K, Barbosa DA, Meier MJ. Second-Generation central venous catheter in the prevention of bloodstream infection: a systematic review. Rev Lat Am Enfermagem. 2016;24:e2722.

    Article  PubMed  PubMed Central  Google Scholar 

  2. 2.

    Ji L, Yang J, Miao J, Shao Q, Cao Y, Li H. Infections related to totally implantable venous-access ports: long-term experience in one center. Cell Biochem Biophys. 2015;72:235–40.

    Article  CAS  PubMed  Google Scholar 

  3. 3.

    Silva TN, Marchi D, Mendes ML, Barretti P, Ponce D. Approach to prophylactic measures for central venous catheter-related infections in hemodialysis: a critical review. Hemodial Int. 2014;18:15–23.

    Article  PubMed  Google Scholar 

  4. 4.

    Yoshida J, Ishimaru T, Kikuchi T, Matsubara N, Asano I. Association between risk of bloodstream infection and duration of use of totally implantable access ports and central lines: a 24-month study. Am J Infect Control. 2011;39:e39–43.

    Article  PubMed  Google Scholar 

  5. 5.

    Covey AM, Toro-Pape FW, Thornton RH, et al. Totally implantable venous access device placement by interventional radiologists: Are prophylactic antibiotics necessary? J Vasc Interv Radiol. 2012;23:358–62.

    Article  PubMed  Google Scholar 

  6. 6.

    Karanlik H, Kurul S, Saip P, et al. The role of antibiotic prophylaxis in totally implantable venous access device placement: results of a single-center prospective randomized trial. Am J Surg. 2011;202:10–5.

    Article  CAS  PubMed  Google Scholar 

  7. 7.

    Di Carlo I, Toro A, Pulvirenti E, Palermo F, Scibilia G, Cordio S. Could antibiotic prophylaxis be not necessary to implant totally implantable venous access devices? Randomized prospective study. Surg Oncol. 2011;20:20–5.

    Article  PubMed  Google Scholar 

  8. 8.

    Johnson E, Babb J, Sridhar D. Routine antibiotic prophylaxis for totally implantable venous access device placement: meta-analysis of 2154 patients. J Vasc Interv Radiol 2016;27:339-43; quiz 44.

  9. 9.

    Nelson ET, Gross ME, Mone MC, Hansen HJ, Nelson EW, Scaife CL. A survey of American College of Surgery fellows evaluating their use of antibiotic prophylaxis in the placement of subcutaneously implanted central venous access ports. Am J Surg. 2013;206:1034–40.

    Article  PubMed  Google Scholar 

  10. 10.

    Shim J, Seo TS, Song MG, et al. Incidence and risk factors of infectious complications related to implantable venous-access ports. Korean J Radiol. 2014;15:494–500.

    Article  PubMed  PubMed Central  Google Scholar 

  11. 11.

    Lebeaux D, Fernandez-Hidalgo N, Chauhan A, et al. Management of infections related to totally implantable venous-access ports: challenges and perspectives. Lancet Infect Dis. 2014;14:146–59.

    Article  CAS  PubMed  Google Scholar 

  12. 12.

    Venkatesan AM, Kundu S, Sacks D, et al. Practice guidelines for adult antibiotic prophylaxis during vascular and interventional radiology procedures. Written by the Standards of Practice Committee for the Society of Interventional Radiology and Endorsed by the Cardiovascular Interventional Radiological Society of Europe and Canadian Interventional Radiology Association [corrected]. J Vasc Interv Radiol 2010;21:1611–30; quiz 31.

  13. 13.

    Scaife CL, Gross ME, Mone MC, et al. Antibiotic prophylaxis in the placement of totally implanted central venous access ports. Am J Surg. 2010;200:719–23.

    Article  PubMed  Google Scholar 

  14. 14.

    Chang L, Tsai JS, Huang SJ, Shih CC. Evaluation of infectious complications of the implantable venous access system in a general oncologic population. Am J Infect Control. 2003;31:34–9.

    Article  PubMed  Google Scholar 

  15. 15.

    Hung KY, Tsai TJ, Yen CJ, Yen TS. Infection associated with double lumen catheterization for temporary haemodialysis: experience of 168 cases. Nephrol Dial Transplant. 1995;10:247–51.

    CAS  PubMed  Google Scholar 

  16. 16.

    Unver S, Atasoyu EM, Evrenkaya TR, Ardic N, Ozyurt M. Risk factors for the infections caused by temporary double-Lumen hemodialysis catheters. Arch Med Res. 2006;37:348–52.

    Article  PubMed  Google Scholar 

  17. 17.

    Ryan JM, Ryan BM, Smith TP. Antibiotic prophylaxis in interventional radiology. J Vasc Interv Radiol. 2004;15:547–56.

    Article  PubMed  Google Scholar 

  18. 18.

    Pandey N, Chittams JL, Trerotola SO. Outpatient placement of subcutaneous venous access ports reduces the rate of infection and dehiscence compared with inpatient placement. J Vasc Interv Radiol. 2013;24:849–54.

    Article  PubMed  Google Scholar 

  19. 19.

    Groeger JS, Lucas AB, Thaler HT, et al. Infectious morbidity associated with long-term use of venous access devices in patients with cancer. Ann Intern Med. 1993;119:1168–74.

    Article  CAS  PubMed  Google Scholar 

  20. 20.

    Khayr W, Haddad RY, Noor SA. Infections in hematological malignancies. Disease-a-month: DM. 2012;58:239–49.

    Article  PubMed  Google Scholar 

  21. 21.

    Samaras P, Dold S, Braun J, et al. Infectious port complications are more frequent in younger patients with hematologic malignancies than in solid tumor patients. Oncology. 2008;74:237–44.

    Article  PubMed  Google Scholar 

  22. 22.

    Norrby SR. Side effects of cephalosporins. Drugs. 1987;34:105–20.

    Article  PubMed  Google Scholar 

  23. 23.

    Brothers TE, Von Moll LK, Niederhuber JE, Roberts JA, Walker-Andrews S, Ensminger WD. Experience with subcutaneous infusion ports in three hundred patients. Surg Gynecol Obstet. 1988;166:295–301.

    CAS  PubMed  Google Scholar 

Download references

Conflict of interest

The authors declare that they have no conflict of interest.

Author information



Corresponding author

Correspondence to Igor Latich.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

This retrospective study qualified for institutional review board waiver.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Nezami, N., Xing, M., Groenwald, M. et al. Risk Factors of Infection and Role of Antibiotic Prophylaxis in Totally Implantable Venous Access Port Placement: Propensity Score Matching. Cardiovasc Intervent Radiol 42, 1302–1310 (2019).

Download citation


  • Port
  • Antibiotic
  • Prophylaxis
  • Infection
  • Removal
  • Central venous
  • Catheter