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Outcome of attempted Hickman catheter salvage in febrile neutropenic cancer patients with Staphylococcus aureus bacteremia

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Abstract

There are limited data on outcomes of Hickman catheter salvage associated with Staphylococcus aureus bacteremia (SAB) in neutropenic cancer patients. We evaluated the outcome of attempted Hickman catheter salvage in these patients who were not given antibiotic lock therapy. Outcomes were retrospectively analyzed in all neutropenic cancer patients with Hickman catheter-related SAB over a 12-year period (56 episodes in 54 patients). Salvage attempts were defined as cases where the catheter was still in place 3 days after initial bacteremia. Salvage attempts were considered successful if catheter was still in place 12 weeks later without recurrent SAB or death. Of the 56 episodes, catheters were immediately removed in eight (14%), and catheter salvage was attempted in 48 (86%). Of these 48 episodes, attempted salvage was successful in 29 (60%) and failed in 14 (29%). Outcome of attempted salvage was indeterminate in five (11%) episodes. In univariate analysis, presence of external signs of catheter infection (p = 0.03), positive follow-up blood culture (p = 0.03), and methicillin resistance (p = 0.04) were significantly associated with catheter salvage failure. In multivariate analysis, presence of external signs of catheter infection (OR 12.0; p = 0.04) and methicillin resistance (OR 5.1; p = 0.04) were independently associated with catheter savage failure. In conclusion, attempted catheter salvage without antibiotic lock therapy was successful in 60% of the patients with Hickman catheter-related SAB. External signs of catheter infection and methicillin resistance were independent risk factors for catheter salvage failure.

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All authors report no conflicts of interest relevant to this article.

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Authors and Affiliations

  1. Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea

    Mi-Na Kim

  2. Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea

    Dae Ho Lee & Cheolwon Suh

  3. Department of Hematology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea

    Dae-Young Kim, Jung-Hee Lee, Je-Hwan Lee & Kyoo-Hyung Lee

  4. Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, 86, Asanbyeongwon-gil, Songpa-gu, Seoul, 138-736, Republic of Korea

    Ki-Ho Park, Oh-Hyun Cho, Sang-Oh Lee, Sang-Ho Choi, Yang Soo Kim, Jun Hee Woo & Sung-Han Kim

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  1. Ki-Ho Park
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  2. Oh-Hyun Cho
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Correspondence to Sung-Han Kim.

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Park, KH., Cho, OH., Lee, SO. et al. Outcome of attempted Hickman catheter salvage in febrile neutropenic cancer patients with Staphylococcus aureus bacteremia. Ann Hematol 89, 1163–1169 (2010). https://doi.org/10.1007/s00277-010-1004-3

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  • DOI: https://doi.org/10.1007/s00277-010-1004-3

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