Advertisement

Supportive Care in Cancer

, Volume 12, Issue 3, pp 197–201 | Cite as

Implantable venous port-related infections in cancer patients

  • Wen-Tsung Huang
  • Tsai-Yun Chen
  • Wu-Chou Su
  • Chia-Jui Yen
  • Chao-Jung TsaoEmail author
Original Article

Abstract

Objectives

To evaluate the characteristics of implantable venous port-related infections in patients with malignancies.

Patients and methods

This was a 6-year study in which all the records of cancer patients who were diagnosed with port-related infections were retrospectively analyzed.

Results

The analysis included 36 episodes of port-related infections. The median period from port implantation to the episode of port-related infection was 164 days (21 to 1650 days). Of the 36 episodes, 15 (42%) were polymicrobial infections, and 21 (58%) were gram-negative pathogens. If only the port-related bacteremia was taken into consideration, gram-negative bacilli and gram-positive cocci accounted for 39 and 7 pathogens of the total 53 isolated microorganisms (74% and 13%, respectively). Stenotrophomonas maltophilia and Acinetobacter baumanii were the predominant causal microorganisms. All except two infectious catheters were removed. No infection-related mortality developed.

Conclusions

Gram-negative bacilli, especially the glucose-non-fermenting pathogens, tend to be the major microorganisms that account for port-related infections, and the infections run a benign course, even those developed in septicemia.

Keywords

Central venous access Implanted device Catheter infection Bacteremia Cancer patient 

References

  1. 1.
    Castagnola E, Garaventa A, Viscoli C, Carrega G, Nantron M, Molinari C (1995) Changing pattern of pathogens causing broviac catheter-related bacteraemias in children with cancer. J Hosp Infect 29:129–133PubMedGoogle Scholar
  2. 2.
    Douard MC, Arlet G, Longuet P, Troje C, Rouveau M, Ponscarme D, Eurin B (1999) Diagnosis of venous access port-related infections. Clin Infect Dis 29:1197–1202CrossRefPubMedGoogle Scholar
  3. 3.
    Elting LS, Bodey GP (1990) Septicemia due to Xanthomonas species and non-aeruginosa Pseudomonas species: increasing incidence of catheter-related infections. Medicine 5:296–306Google Scholar
  4. 4.
    Elting LS, Rubenstein EB, Rolston KVI, Bodey GP (1997) Outcomes of bacteremia in patients with cancer and neutropenia: observation from two decades of epidemiological and clinical trials. Clin Infect Dis 25:247–259PubMedGoogle Scholar
  5. 5.
    Friedman ND, Korman TM, Fairley CK, Franklin JC, Spelman DW (2002) Bacteremia due to Stenotrophomonas maltophilia: an analysis of 45 episodes. J Infect 45:47–53CrossRefPubMedGoogle Scholar
  6. 6.
    Giamarellou H, Antoniadou A (2001) Infectious complications of febrile leucopenia. Infect Dis Clin North Am 15:457–482PubMedGoogle Scholar
  7. 7.
    Gill MV, Klein NC, Cunha BA (1996) Unusual organisms causing intravenous line infections in compromised hosts: I. Bacterial and algal infections. Infect Dis Clin Pract 5:244–255Google Scholar
  8. 8.
    Groeger JS, Lucas AB, Thaler HT, Friedlander-Klar H (1993) Infectious morbidity associated with long-term use of venous access devices in patients with cancer. Ann Intern Med 119:1168–1174Google Scholar
  9. 9.
    Ingram J, Weitzman S, Greenberg ML, Parkin P, Filler R (1991) Complications of indwelling venous access lines in the pediatric hematology patient: a prospective comparison of external venous catheters and subcutaneous ports. Am J Pediatr Hematol Oncol 13:130–136PubMedGoogle Scholar
  10. 10.
    Keung YK, Watkins K, Chen SC, Groshen S, Silberman H, Douer D (1994) Comparative study of infectious complications of different types of chronic central venous access devices. Cancer 73:2832–2837Google Scholar
  11. 11.
    Kiehn TE, Armstrong D (1990) Changes in the spectrum of organisms causing bacteremia and fungemia in immunocompromised patients due to venous access devices. Eur J Clin Microbiol Infect Dis 9:869–872PubMedGoogle Scholar
  12. 12.
    Kluger DM, Maki DG (2000) A meta-analysis of the risk of intravascular device-related bloodstream infection based on 223 published prospective studies (abstract). Infect Control Hosp Epidemiol 2:95Google Scholar
  13. 13.
    Kryzwda EA, Andris DA, Edmiston CE, Quebbeman EJ (1995) Treatment of Hickman catheter sepsis using antibiotic lock technique. Infect Control Hosp Epidemiol 16:596–598PubMedGoogle Scholar
  14. 14.
    Ku SC, Hsueh PR, Yang PC, Luh KT (2000) Clinical and microbiological characteristics of bacteremia caused by Acinetobacter lwoffi. Eur J Clin Microbiol Infect Dis 19:501–505CrossRefPubMedGoogle Scholar
  15. 15.
    Martino R, Santamaria A, Munoz L, Pericas R, Altes A, Prats G, Sierra J (1999) Bacteremia by gram-negative bacilli in patients with hematological malignancies. Acta Haematol 102:7–11CrossRefPubMedGoogle Scholar
  16. 16.
    Martino R, Gomez L, Pericas R, Salazar R, Sola C, Sierra J, Garau J (2000) Bacteremia caused by non-glucose-fermenting gram-negative bacilli and Aeromonas species in patients with haematological malignancies and solid tumours. Eur J Clin Infect Dis 19:320–323CrossRefGoogle Scholar
  17. 17.
    Mermel LA, Farr BM, Sherertz RJ, Raad II, O’Grady N, Harris JS, Craven DE (2001) Guidelines for the management of intravascular catheter-related infections. Clin Infect Dis 32:1249–1272PubMedGoogle Scholar
  18. 18.
    Mueller BU, Skelton J, Callender DPE, Marshall D, Gress J, Long D (1992) A prospective randomized trial comparing the infectious complications of the externalized catheters versus a subcutaneously implanted device in cancer patients. J Clin Oncol 10:1943–1948PubMedGoogle Scholar
  19. 19.
    Pegues D, Axelrod P, McClarren C, Eisenberg BL, Hoffman JP, Ottery FD (1992) Comparison of infections in Hickman and implanted port catheters in adult solid tumor patients. J Surg Oncol 49:156–162PubMedGoogle Scholar
  20. 20.
    Rao JS, O’Meara A, Harvey T, Breathnach F (1992) A new approach to the management of Broviac catheter infection. J Hosp Infect 22:109–116PubMedGoogle Scholar
  21. 21.
    Sotir MJ, Lewis C, Bisher EW, Ray SM (1999) Epidemiology of device-associated infections related to a long-term implantable vascular access device. Infect Control Hosp Epidemiol 20:187–191PubMedGoogle Scholar
  22. 22.
    Tancrede CH, Andremont AO (1985) Bacterial translocation and gram negative bacteremia in patients having hematological malignancies. J Infect Dis 15:99–103Google Scholar
  23. 23.
    Whitman ED, Boatman AM (1995) Comparison of diagnostic specimens and methods to evaluate infected venous access ports. Am J Surg 170:665–670CrossRefPubMedGoogle Scholar
  24. 24.
    Zinner SH (1999) Changing epidemiology of infections in patients with neutropenia and cancer: emphasis on gram-positive and resistant bacteria. Clin Infect Dis 29:490–494PubMedGoogle Scholar

Copyright information

© Springer-Verlag 2004

Authors and Affiliations

  • Wen-Tsung Huang
    • 1
  • Tsai-Yun Chen
    • 1
  • Wu-Chou Su
    • 1
  • Chia-Jui Yen
    • 1
  • Chao-Jung Tsao
    • 1
    Email author
  1. 1.Division of Hematology/Oncology, Department of Internal MedicineNational Cheng Kung University Hospital College of MedicineTainan 704Republic of China

Personalised recommendations