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The Risk of Infection Associated With Intra-arterial Catheters for Cancer Chemotherapy

Published online by Cambridge University Press:  02 January 2015

Issam Raad ,
Dima Abi-Said ,
Cesar H. Carrasco ,
Jan Umphrey  and
Lou Anne Hill
Issam Raad*
Affiliation:
Department of Medical Specialties, Section of Infection Control, The University of Texas MD Anderson Cancer Center, Houston, Texas
Dima Abi-Said
Affiliation:
Department of Medical Specialties, Sections of Infectious Diseases, The University of Texas MD Anderson Cancer Center, Houston, Texas
Cesar H. Carrasco
Affiliation:
Department of Diagnostic Radiology, Angiography/Interventional Radiology Section, The University of Texas MD Anderson Cancer Center, Houston, Texas
Jan Umphrey
Affiliation:
Department of Medical Specialties, Section of Infection Control, The University of Texas MD Anderson Cancer Center, Houston, Texas
Lou Anne Hill
Affiliation:
Department of Medical Specialties, Section of Infection Control, The University of Texas MD Anderson Cancer Center, Houston, Texas Department of Diagnostic Radiology, Angiography/Interventional Radiology Section, The University of Texas MD Anderson Cancer Center, Houston, Texas
*
Section of Infection Control, Box 47, UTMD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030
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Abstract

Objective:

To determine the frequency of, and risk factors for, infections associated with intra-arterial catheters used for cancer chemotherapy.

Methods:

Between September 1992 and September 1995, we conducted a surveillance study of all 807 intra-arterial catheters placed for chemotherapy at our center. The insertion site was disinfected with povidone iodine and alcohol, and the arterial catheter was placed using maximal sterile barrier precautions. Upon removal, all intravascular segments were submitted for semiquantitative culture.

Results:

No episodes of catheter-related bloodstream infection (95% confidence interval [CI95], 0%-1.6%) were observed. However, the risk of colonization (>15 colony-forming units) of arterial catheters was 15% (CI95, 12%-17%). Retrospective risk-factor analysis conducted on 224 intra-arterial catheters placed for chemotherapy in 1993 showed that colonization was associated significantly with duration of catheterization (median of 1 day for culture-negative catheters vs median of 4 days for culture-positive catheters, P<.001). Age, gender, prior radiotherapy, underlying cancer, neutropenia, and hypoalbuminemia were not associated with catheter colonization.

Conclusion:

Intra-arterial catheters for cancer chemotherapy placed under maximal sterile barrier precautions for a short period of time are associated with a very low risk of bloodstream infection.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 19 , Issue 9 , September 1998 , pp. 640 - 642
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1998

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