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Outcomes of Hickman Catheter Salvage in Febrile Neutropenic Cancer Patients With Staphylococcus aureus Bacteremia

Published online by Cambridge University Press:  02 January 2015

Sung-Han Kim
Affiliation:
Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
Cheol-In Kang
Affiliation:
Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
Hong-Bin Kim
Affiliation:
Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
Sung-Soo Youn
Affiliation:
Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
Myoung-don Oh*
Affiliation:
Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea Clinical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea
Eui-Chong Kim
Affiliation:
Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea Clinical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea
Seon-Yang Park
Affiliation:
Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
Byoung-Kook Kim
Affiliation:
Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
Kang-Won Choe
Affiliation:
Clinical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea
*
Department of Internal Medicine, Seoul National University Hospital, 28 Youngun-dong, Chongro-gu, Seoul, Republic of Korea, 110-744

Abstract

Objective:

To evaluate the outcome of attempted Hickman catheter salvage in neutropenic cancer patients with Staphylococcus aureus bacteremia who were not using antibiotic lock therapy.

Design:

Retrospective cohort study.

Setting:

A university-affiliated, tertiary-care hospital with 1,500 beds for adult patients.

Patients:

All neutropenic cancer patients who had a Hickman catheter and S. aureus bacteremia (32 episodes in 29 patients) between January 1998 and March 2002.

Methods:

Salvage attempts were defined as cases where the Hickman catheter was not removed until we obtained the results of follow-up blood cultures performed 48 to 72 hours after starting treatment with antistaphylococcal antibiotics. Salvage was considered to be successful if the Hickman catheter was still in place 3 months later without recurrent bacteremia or death.

Results:

Catheter salvage was attempted in 24 (75%) of the 32 episodes. Of the salvage attempts, the success rate was 50% (12 of 24). Salvage attempts were successful in 14% (1 of 7) of the episodes with positive follow-up blood cultures, and in 65% (11 of 17) of those with negative follow-up blood cultures (P = .07). If the analysis is confined to cases with no external signs of catheter infection, salvage attempts were successful in 14% (1 of 7) of the episodes with positive follow-up blood cultures and in 80% (8 of 10) of those with negative follow-up blood cultures (P = .02).

Conclusion:

In neutropenic cancer patients with S. aureus bacteremia, attempted catheter salvage without antibiotic lock therapy was successful in 50% of the cases.

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2003

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References

1.Yip, C, Rotstein, C. Hickman catheter-related infections in patients with cancer. Int J Antimicrob Agents 1998;10:181189.CrossRefGoogle ScholarPubMed
2.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;119:11681174.CrossRefGoogle ScholarPubMed
3.Hughes, WT, Armstrong, D, Bodey, GP, et al. 2002 guidelines for the use of antimicrobial agents in neutropenic patients with cancer. Clin Infect Dis 2002;34:730751.CrossRefGoogle Scholar
4.Gonzalez-Barca, E, Fernandez-Sevilla, A, Carratala, J, et al. Prospective study of 288 episodes of bacteremia in neutropenic cancer patients in a single institution. Eur J Clin Microbiol Infect Dis 1996;15:291296.CrossRefGoogle Scholar
5.Press, OW, Ramsey, PG, Larson, EB, et al. Hickman catheter infections in patients with malignancies. Medicine 1984;64:189200.CrossRefGoogle Scholar
6.Dugdale, DC, Ramsey, PG. Staphylococcus aureus bacteremia in patients with Hickman catheters. Am J Med 1990;89:137141.CrossRefGoogle ScholarPubMed
7.Mermel, LA, Farr, BM, Sherertz, RJ, et al. Guidelines for the management of intravascular catheter-related infections. Infect Control Hosp Epidemiol 2001;22:222242.CrossRefGoogle ScholarPubMed
8.National Committee for Clinical Laboratory Standards. Performance Standards for Antimicrobial Disk Susceptibility Tests. Villanova, PA: National Committee for Clinical Laboratory Standards; 1993. Approved standard M2-A5.Google Scholar
9.Soriano, A, Martinez, JA, Mensa, J, et al. Pathogenic significance of methicillin resistance for patients with Staphylococcus aureus bacteremia. Clin Infect Dis 2000;30:368373.CrossRefGoogle ScholarPubMed
10.Marr, KA, Sexton, DJ, Conlon, PJ, Corey, GR, Schwab, SJ, Kirkland, KB. Catheter-related bacteremia and outcome of attempted catheter salvage in patients undergoing hemodialysis. Ann Intern Med 1997;127:275280.CrossRefGoogle ScholarPubMed
11.Petersen, FB, Clift, RA, Hickman, RO, et al. Hickman catheter complications in marrow transplant recipients. JPEN J Parenter Enteral Nutr 1985;10:5862.CrossRefGoogle ScholarPubMed
12.Hiemenz, J, Skelton, J, Pizzo, PA. Perspective on the management of catheter-related infections in cancer patients. Pediatr Infect Dis 1986;5:611.CrossRefGoogle ScholarPubMed
13.Johnson, PR, Decker, MD, Edwards, KM, et al. Frequency of Broviac catheter infections in pediatric oncology patients. J Infect Dis 1986;154:570578.CrossRefGoogle ScholarPubMed
14.Benezra, D, Kiehn, TE, Gold, JW, et al. Prospective study of infections in indwelling central venous catheters using quantitative blood cultures. Am J Med 1988;85:495498.CrossRefGoogle ScholarPubMed
15.Mirro, J, Rao, BN, Stokes, DC, et al. A prospective study of Hickman/Broviac catheters and implantable ports in pediatric oncology patients. J Clin Oncol 1989;7:214222.CrossRefGoogle ScholarPubMed
16.Ulz, L, Petersen, FB, Ford, R, et al. A prospective study of complications in Hickman right-atrial catheters in marrow transplant patients. JPEN J Parenter Enteral Nutr 1990; 14:2730.CrossRefGoogle Scholar
17.Rotstein, C, Brock, L, Roberts, RS. The incidence of first Hickman catheter-related infection and predictors of catheter removal in cancer patients. Infect Control Hosp Epidemiol 1995;16:451458.CrossRefGoogle ScholarPubMed
18.Elishoov, H, Or, R, Strauss, N, et al. Nosocomial colonization, septicemia, and Hickman/Broviac catheter-related infections in bone marrow transplant recipients. Medicine 1998;77:83101.CrossRefGoogle ScholarPubMed
19.Lecciones, JA, Lee, JW, Navarro, EE, et al. Vascular catheter-related fungemia in patients with cancer: analysis of 155 episodes. Clin Infect Dis 1992;14:975983.CrossRefGoogle Scholar
20.Siegman-Igra, Y, Anglim, AM, Shapiro, DE, et al. Diagnosis of vascular catheter-related bloodstream infection: meta-analysis. J Clin Microbiol 1997;35:928936.Google ScholarPubMed
21.Flynn, PM, Shenep, JL, Barrett, FF. Differential quantitation with a commercial blood culture tube for diagnosis of catheter-related infection. J Clin Microbiol 1998;26:10451046.Google ScholarPubMed
22.Capdevila, JA, Planes, AM, Palomar, M, et al. Value of differential quantitative blood cultures in the diagnosis of catheter-related sepsis. Eur J Clin Microbiol Infect Dis 1992;11:403407.CrossRefGoogle Scholar
23.Blot, F, Nitenberg, G, Chachaty, E, et al. Diagnosis of catheter-related bacteremia: a prospective comparison of the time to positivity of hub-blood versus peripheral-blood cultures. Lancet 1999;354:10711077.CrossRefGoogle ScholarPubMed
24.Pearson, ML. Hospital Infection Control Practices Advisory Committee (HICPAC): guideline for prevention of intravascular-device-related infections. Infect Control Hosp Epidemiol 1996;17:438473.CrossRefGoogle Scholar
25.Capdevila, JA, Segarra, A, Planes, AM, et al. Successful treatment of hemodialysis catheter-related sepsis without catheter removal. Nephrol Dial Transplant 1993;8:231234.Google ScholarPubMed
26.Berrington, A, Could, FK. Use of antibiotics locks to treat colonized central venous catheters. J Antimicrob Chemother 2001;48:597603.CrossRefGoogle ScholarPubMed
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