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Single-Lumen Subcutaneous Ports Inserted by Interventional Radiologists in Patients Undergoing Chemotherapy
Incidence of Infection and Outcome of Attempted Catheter Salvage
Delia Kuizon, MD;
Steven M. Gordon, MD;
Bart L. Dolmatch, MD
Arch Intern Med. 2001;161:406-410.
Background Subcutaneous ports are commonly used for vascular access in patients
with cancer undergoing chemotherapy.
Objectives To determine the incidence of catheter-related infection and to assess
the efficacy of catheter salvage in subcutaneous ports.
Methods We retrospectively reviewed 300 subcutaneous single-lumen chest ports
inserted by interventional radiologists in 294 patients between December 1,
1995, and November 15, 1997, at the Cleveland Clinic Foundation, Cleveland,
Ohio. The number of days that the catheter remained in situ, infection rate,
treatment, and outcome of infection were determined.
Results Two hundred ninety-four patients had a total of 79 748 catheter-days.
Vascular access for chemotherapy was the indication for 95% of the subcutaneous
ports placed. Seventeen catheters (5.7%) developed 20 episodes of noninfectious
complications resulting in the removal of 6 ports. Seventeen patients (5.7%)
developed catheter-related infections (2.1/10 000 catheter-days) including
10 episodes of catheter-related bacteremia (1.2/10 000 catheter-days).
The most common organism isolated was Staphylococcus aureus. A total of 15 of the 17 infected catheters were removed. Salvage
was attempted in 6 patients in whom 4 catheters were eventually removed due
to recurrent bacteremia (2 patients) and persistent local infection (2 patients).
One of the 10 patients with catheter-related bacteremia developed septic arthritis.
There were no complications associated with attempted catheter salvage.
Conclusions Subcutaneous single-lumen ports inserted by interventional radiologists
in patients undergoing chemotherapy have low complication rates but infections
remain the leading cause of catheter loss. Antibiotic therapy without catheter
removal is unlikely to eradicate catheter-related bacteremia.
From the Departments of Internal Medicine (Dr Kuizon), Infectious Diseases
(Dr Gordon), and Interventional Radiology (Dr Dolmatch), Cleveland Clinic
Foundation, Cleveland, Ohio. Dr Dolmatch is now with the Department of Radiology,
The University of Texas, Southwestern Medical Center, Dallas.
Corresponding author: Steven M. Gordon, MD, Department of Infectious
Diseases, Mailstop S-32, 9500 Euclid Ave, Cleveland, OH 44195.
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