An analysis of totally implantable central venous port system infections in an urban tertiary referral center

J Chemother. 2021 Jul;33(4):228-237. doi: 10.1080/1120009X.2020.1829327. Epub 2020 Oct 8.

Abstract

A frequent complication of central venous port systems (CVP) is infection (CVP-I), either local (CVP-LI) or a life-threatening blood stream infection (CVP-BSI). We examined the course of CVP-I including results of an antibiotic eradication attempt of CVP-BSI. We investigated adults with CVP-I from 2010 to 2018 who had to undergo port explantation or were treated by a combination of systemic antibiotics and antibiotic lock therapy (ALT). In nine years we diagnosed 206 CVP-I (CVP-LI: 52; CVP-BSI: 152). In 146 patients with CVP-I the port system was primary explanted, while 56 patients received antibiotics/ALT. 79% of Gram negative pathogens and 50% of coagulase negative staphylococci (CoNS) were eradicated. Failure of antibiotic treatment was more often associated with short time span since CVP implantation, neutropenia and polymicrobial infection. All patients with non-neoplastic disease survived, while 18/173 patients (10%) with underlying malignant disease had a fatal outcome in the same hospital stay.

Keywords: Central venous port infection; Gram negative pathogens; antibiotic lock therapy (ALT); antibiotics; blood stream infection; coagulase negative staphylococci; oncologic patients.

MeSH terms

  • Aged
  • Anti-Bacterial Agents / therapeutic use*
  • Catheter-Related Infections / drug therapy*
  • Catheter-Related Infections / epidemiology*
  • Catheter-Related Infections / microbiology
  • Central Venous Catheters / microbiology*
  • Female
  • Gram-Negative Bacteria / drug effects
  • Gram-Negative Bacteria / isolation & purification
  • Gram-Positive Bacteria / drug effects
  • Gram-Positive Bacteria / isolation & purification
  • Humans
  • Male
  • Middle Aged
  • Retrospective Studies
  • Tertiary Care Centers

Substances

  • Anti-Bacterial Agents