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Long-Term Central Venous Catheter Infection in HIV-infected and Cancer Patients: A Multicenter Cohort Study

  • Pascal Astagneau (a1), Sylvie Maugat (a1), Tuan Tran-Minh (a1), Marie-Cécile Douard (a2), Pascale Longuet (a2), Caroline Maslo (a2), Régis Parte (a2), Annick Macrez (a2) and Gilles Brücker (a1) (a2)...

Abstract

Objectives:

To evaluate and compare the risk of long-term central venous catheter (CVC) infection in human immunodeficiency virus (HIV)-infected and cancer patients.

Design:

Prospective multicenter cohort study based on active surveillance of long-term CVC manipulations and patient outcome over a 6-month period.

Setting:

Services of infectious diseases and oncology of 12 university hospitals in Paris, France.

Participants:

In 1995, all HIV and cancer patients with solid malignancy were included at the time of long-term CVC implantation.

Results:

Overall, 31.6% of long-term CVC infections were identified in 32% of 201 HIV and 5% of 255 cancer patients. Most were associated with bacteremia, most commonly coagulase-negative staphylococci. The long-term CVC time-related infection risk was greater in HIV than in cancer patients (3.78 vs 0.39 infections per 1,000 long-term CVC days; P<.001). The independent risk factors of long-term CVC infection were as follows: in HIV patients, frequency of long-term CVC handling and neutropenia; in cancer patients, poor Karnofsky performance status; in both HIV and cancer patients, recent history of bacterial infection. The risk of long-term CVC infection was similar for tunneled catheters and venous access ports in each population.

Conclusions:

Prevention of long-term CVC infection should focus first on better sterile precautions while handling long-term CVC, especially in HIV patients who have frequent and daily use of the long-term CVC.

Copyright

Corresponding author

C-CLIN Paris Nord, Institut des Cordeliers, 15 rue de l'Ecole de Médecine, 75006 Paris, France

References

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Long-Term Central Venous Catheter Infection in HIV-infected and Cancer Patients: A Multicenter Cohort Study

  • Pascal Astagneau (a1), Sylvie Maugat (a1), Tuan Tran-Minh (a1), Marie-Cécile Douard (a2), Pascale Longuet (a2), Caroline Maslo (a2), Régis Parte (a2), Annick Macrez (a2) and Gilles Brücker (a1) (a2)...

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