Skip to main content
SpringerLink
Log in

Impact of the insertion site of central venous catheters on central venous catheter-related bloodstream infections in patients with cancer: results from a large prospective registry

  • Brief Report
  • Published:
Infection Aims and scope Submit manuscript

Abstract

Purpose

Overall, insertion of central venous catheter (CVC) into femoral veins (FV) has been shown to be associated with a higher risk of infection compared with subclavian and internal jugular (IJV/SCV) CVC, but no data are available on the impact of the FV insertion site on the CVC-related bloodstream infections (CRBSI) risk in patients with cancer. The objective of the study is to compare CRBSI rates and incidences of FV with those of internal jugular and subclavian vein (IJV/SCV CVC) as observed in the prospective SECRECY registry.

Methods

SECRECY is an ongoing observational, prospective, clinical CRBSI registry active in six departments of hematology/oncology in Germany. Each case of FV CVC was matched at a ratio of 1:1 to a case with IJV/SCV CVC. The propensity score was estimated using a multivariable logistic regression model adjusting for age, sex, cancer type, and duration of indwelling catheter.

Results

Of 4268 CVCs included in this analysis, 52 (1.2%) were inserted into the FV and 4216 (98.8%) into the IJV/SCV. 52 cases of FV CVC were matched with 52 IJV/SCV CVC. There was no significant difference in the CRBSI rate (3.8% vs. 9.6%), the CRBSI incidence (5.7 vs. 14.2/1000 CVC days), and the median CVC time (5.5 vs. 5 days) between the FV and the IJV/SCV group.

Conclusion

Based on this data, inserting FV CVCs in patients with cancer does, at least in the short-term, not appear to be associated with an increased risk of CRBSI as compared to IJV/SCV CVC.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Availability of data and materials

The data that support the findings of this study are available from the corresponding author upon reasonable request.

References

  1. Böll B, Schalk E, Buchheidt D, et al. Central venous catheter-related infections in hematology and oncology: 2020 updated guidelines on diagnosis, management and prevention by the Infectious Diseases Working Party (AGIHO) of the German Society of Hematology and Medical Oncology (DGHO). Ann Hematol. 2021;100:239–59.

    Article  PubMed  Google Scholar 

  2. O’Grady NP, Alexander M, Burns LA, et al. Healthcare Infection Control Practices Advisory Committee (HICPAC). Guidelines for the prevention of intravascular catheter-related infections. Clin Infect Dis. 2011;52:e162-93.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Parienti JJ, Mongardon N, Mégarbane B, et al. Intravascular complications of central venous catheterization by insertion site. N Engl J Med. 2015;373:1220–9.

    Article  CAS  PubMed  Google Scholar 

  4. Arvaniti K, Lathyris D, Blot S, et al. Cumulative evidence of randomized controlled and observational studies on catheter related infection risk of central venous catheter insertion site in ICU patients: a pairwise and network meta-analysis. Crit Care Med. 2017;45:e437–48.

    Article  PubMed  Google Scholar 

  5. Parienti JJ. Catheter-related bloodstream infection in jugular versus subclavian central catheterization. Crit Care Med. 2017;45:e734–5.

    Article  PubMed  Google Scholar 

  6. Rixecker T, Lesan V, Ahlgrimm M, et al. Insertion site of central venous catheter correlates with catheter-related infectious events in patients undergoing intensive chemotherapy. Bone Marrow Transplant. 2021;56:195–201.

    Article  CAS  PubMed  Google Scholar 

  7. Heidenreich D, Hansen E, Kreil S, et al. The insertion site is the main risk factor for central venous catheter-related complications in patients with hematologic malignancies. Am J Hematol. 2022;97:303–10.

    Article  PubMed  Google Scholar 

  8. Kommission für Krankenhaushygiene und Infektionsprävention (KRINKO) beim Robert Koch-Institut. Prävention von Infektionen, die von Gefäßkathetern ausgehen Teil 1 – Nichtgetunnelte zentralvenöse Katheter. Bundesgesundheitsbl. 2017;60:171–206.

    Article  Google Scholar 

  9. Hentrich M, Schalk E, Schmidt-Hieber M, et al. Central venous catheter-related infections in hematology and oncology: 2012 updated guidelines on diagnosis, management and prevention by the Infectious Diseases Working Party of the German Society of Hematology and Medical Oncology. Ann Oncol. 2014;25:936–47.

    Article  CAS  PubMed  Google Scholar 

  10. Schalk E, Tölle D, Schulz S, et al. Identifying haematological cancer patients with high risk for central venous catheter (CVC)-related bloodstream infections at the time point of CVC insertion. 29th European Congress of Clinical Microbiology and Infectious Diseases, April 13–16, 2019, Amsterdam, The Netherlands, abstract P2556. https://www.escmid.org/escmid_publications/escmid_elibrary. Published 2019. Accessed 30 May 2022.

  11. Ho DE, Imai K, King G, Stuart EA. MatchIt: Nonparametric preprocessing for parametric causal inference. J Stat Softw. 2011;42(8):1–28. https://doi.org/10.18637/jss.v042.i08.

    Article  Google Scholar 

  12. Timsit JF, Bouadma L, Mimoz O, et al. Jugular versus femoral short-term catheterization and risk of infection in intensive care unit patients. Causal analysis of two randomized trials. Am J Respir Crit Care Med. 2013;188:1232–9.

    Article  PubMed  Google Scholar 

  13. Heidenreich D, Hansen E, Kreil S, et al. Influence of the insertion site on central venous catheter-related complications in patients undergoing allogeneic hematopoietic cell transplantation. Biol Blood Marrow Transplant. 2020;26:1189–94.

    Article  PubMed  Google Scholar 

  14. Snarski E, Stringer J, Mikulska M, et al. Risk of infectious complications in adult patients after allogeneic hematopoietic stem cell transplantation depending on the site of central venous catheter insertion-multicenter prospective observational study, from the IDWP EBMT and Nurses Group of EBMT. Bone Marrow Transplant. 2021;56:2929–33.

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgements

The authors thank all SECRECY staff for their great support.

Funding

The authors received no financial support for the research, authorship, and/or publication of this article.

Author information

Author notes

  1. Marcus Hentrich and Boris Böll have contributed equally to this work.

Authors and Affiliations

  1. Department of Hematology and Oncology, Red Cross Hospital Munich, University of Munich, Nymphenburger Str. 163, 80634, Munich, Germany

    Marcus Hentrich & Julia Neitz

  2. Department of Internal Medicine I, University Hospital of Cologne, Cologne, Germany

    Boris Böll & Jan-Hendrik Naendrup

  3. Center for Integrated Oncology (CIO), Aachen, Bonn, Cologne, Düsseldorf (ABCD), Aachen, Germany

    Boris Böll, Jens Panse, Jan-Hendrik Naendrup & Eva Fiegle

  4. Department of Internal Medicine II, University Hospital Würzburg, Würzburg, Germany

    Daniel Teschner

  5. Department of Hematology, Medical Oncology, and Pneumology, University Medical Center of the, Johannes Gutenberg University Mainz, Mainz, Germany

    Daniel Teschner & Timo Schmitt

  6. Department of Oncology, Hematology, Hemostaseology and Stem Cell Transplantation, University Hospital RWTH Aachen, Aachen, Germany

    Jens Panse & Eva Fiegle

  7. Hamm Hospital Nahetal, Bad Kreuznach, Germany

    Timo Schmitt

  8. Clinic of Hematology, Oncology, Pneumology and Nephrology, Carl-Thiem Hospital Cottbus, Cottbus, Germany

    Martin Schmidt-Hieber

  9. Department of Hematology and Oncology, Medical Center, Otto-Von-Guericke University Magdeburg, Magdeburg, Germany

    Enrico Schalk

Authors
  1. Marcus Hentrich
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Boris Böll
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Daniel Teschner
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jens Panse
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Timo Schmitt
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Jan-Hendrik Naendrup
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Martin Schmidt-Hieber
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Julia Neitz
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Eva Fiegle
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Enrico Schalk
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

MH was involved in patient management, designed the study, collected and interpreted the data, and wrote the manuscript. BB was involved in patient management, performed statistical analyses, and revised the manuscript. DT was involved in patient management, and revised the manuscript. JP was involved in patient management, and revised the manuscript. TS was involved in patient management, collected the data, and revised the manuscript. J-HN was involved in patient management, collected the data, and revised the manuscript. MS-H was involved in patient management, and revised the manuscript. JN was involved in patient management, collected the data, and revised the manuscript. EF was involved in patient management, collected the data, and revised the manuscript. ES was involved in patient management, designed the study, collected and analyzed the data, and revised the manuscript. All authors approved the final version of the manuscript.

Corresponding author

Correspondence to Marcus Hentrich.

Ethics declarations

Conflict of interest

All authors have no competing interests to declare that are relevant to the content of this article.

Ethical approval

The registry was approved by the central ethics committee (Magdeburg University Hospital, approval no. 84/14) as well as by respective local ethic committees.

Patient consent to participate

Given the nature of routine clinical data and the anonymization of patient data, written informed consent was not required within the study.

Patient consent to publish

Written informed consent was not required within the study.

Supplementary Information

Below is the link to the electronic supplementary material.

Supplementary file1 (DOCX 15 KB)

15010_2023_2029_MOESM2_ESM.tiff

Supplementary Figure 1. Cumulative CRBSI incidence (propensity score matching with 52 FV and 52 IJV CVC; P = .269 [log-rank test]). Supplementary file2 (TIFF 9229 KB)

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Hentrich, M., Böll, B., Teschner, D. et al. Impact of the insertion site of central venous catheters on central venous catheter-related bloodstream infections in patients with cancer: results from a large prospective registry. Infection 51, 1153–1159 (2023). https://doi.org/10.1007/s15010-023-02029-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s15010-023-02029-4

Keywords

Search

Navigation