Cancer Res Treat.  2014 Jul;46(3):250-260.

A Case-Control Study to Identify Risk Factors for Totally Implantable Central Venous Port-Related Bloodstream Infection

• Lee GJ
• Hong SH
• Roh SY
• Park SR
• Lee MA
• Chun HG
• Hong YS
• Kang JH
• Kim SI
• Kim YJ
• Chun HJ
• Oh JS

Abstract

PURPOSE
To date, the risk factors for central venous port-related bloodstream infection (CVP-BSI) in solid cancer patients have not been fully elucidated. We conducted this study in order to determine the risk factors for CVP-BSI in patients with solid cancer.
MATERIALS AND METHODS
A total of 1,642 patients with solid cancer received an implantable central venous port for delivery of chemotherapy between October 2008 and December 2011 in a single center. CVP-BSI was diagnosed in 66 patients (4%). We selected a control group of 130 patients, who were individually matched with respect to age, sex, and catheter insertion time.
RESULTS
CVP-BSI occurred most frequently between September and November (37.9%). The most common pathogen was gram-positive cocci (n=35, 53.0%), followed by fungus (n=14, 21.2%). Multivariate analysis identified monthly catheter-stay as a risk factor for CVP-BSI (p=0.000), however, its risk was lower in primary gastrointestinal cancer than in other cancer (p=0.002). Initial metastatic disease and long catheter-stay were statistically significant factors affecting catheter life span (p=0.005 and p=0.000). Results of multivariate analysis showed that recent transfusion was a risk factor for mortality in patients with CVP-BSI (p=0.047).
CONCLUSION
In analysis of the results with respect to risk factors, prolonged catheter-stay should be avoided as much as possible. It is necessary to be cautious of CVP-BSI in metastatic solid cancer, especially non-gastrointestinal cancer. In addition, avoidance of unnecessary transfusion is essential in order to reduce the mortality of CVP-BSI. Finally, considering the fact that confounding factors may have affected the results, conduct of a well-designed prospective controlled study is warranted.

Keyword

Neoplasms; Catheter-related infections; Risk factors

MeSH Terms

Case-Control Studies*
Catheter-Related Infections
Catheters
Drug Therapy
Fungi
Gastrointestinal Neoplasms
Gram-Positive Cocci
Humans
Mortality
Multivariate Analysis
Risk Factors*

Figure

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  Fig. 1. Factors, initial disease status (A) and monthly catheter-stay duration (B), affecting on catheter life span by Kaplan-Meier analysis.

Reference

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