This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on ISI (7)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Topic Collections  • Bacterial Infections  • Alert me on articles by topic

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.