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Long-Term Central Venous Catheter Infection in HIV-infected and Cancer Patients: A Multicenter Cohort Study

Published online by Cambridge University Press:  02 January 2015

Pascal Astagneau ,
Sylvie Maugat ,
Tuan Tran-Minh ,
Marie-Cécile Douard ,
Pascale Longuet ,
Caroline Maslo ,
Régis Parte ,
Annick Macrez  and
Gilles Brücker
Pascal Astagneau*
Affiliation:
Centre inter-régional de coordination de la lutte contre l'infection nosocomiale (C-CLIN) Paris-Nord, Paris, France
Sylvie Maugat
Affiliation:
Centre inter-régional de coordination de la lutte contre l'infection nosocomiale (C-CLIN) Paris-Nord, Paris, France
Tuan Tran-Minh
Affiliation:
Centre inter-régional de coordination de la lutte contre l'infection nosocomiale (C-CLIN) Paris-Nord, Paris, France
Marie-Cécile Douard
Affiliation:
Assistance Publique-Hôpitaux de paris, Paris, France
Pascale Longuet
Affiliation:
Assistance Publique-Hôpitaux de paris, Paris, France
Caroline Maslo
Affiliation:
Assistance Publique-Hôpitaux de paris, Paris, France
Régis Parte
Affiliation:
Assistance Publique-Hôpitaux de paris, Paris, France
Annick Macrez
Affiliation:
Assistance Publique-Hôpitaux de paris, Paris, France
Gilles Brücker
Affiliation:
Centre inter-régional de coordination de la lutte contre l'infection nosocomiale (C-CLIN) Paris-Nord, Paris, France Assistance Publique-Hôpitaux de paris, Paris, France
*
C-CLIN Paris Nord, Institut des Cordeliers, 15 rue de l'Ecole de Médecine, 75006 Paris, France
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Abstract

Objectives:

To evaluate and compare the risk of long-term central venous catheter (CVC) infection in human immunodeficiency virus (HIV)-infected and cancer patients.

Design:

Prospective multicenter cohort study based on active surveillance of long-term CVC manipulations and patient outcome over a 6-month period.

Setting:

Services of infectious diseases and oncology of 12 university hospitals in Paris, France.

Participants:

In 1995, all HIV and cancer patients with solid malignancy were included at the time of long-term CVC implantation.

Results:

Overall, 31.6% of long-term CVC infections were identified in 32% of 201 HIV and 5% of 255 cancer patients. Most were associated with bacteremia, most commonly coagulase-negative staphylococci. The long-term CVC time-related infection risk was greater in HIV than in cancer patients (3.78 vs 0.39 infections per 1,000 long-term CVC days; P<.001). The independent risk factors of long-term CVC infection were as follows: in HIV patients, frequency of long-term CVC handling and neutropenia; in cancer patients, poor Karnofsky performance status; in both HIV and cancer patients, recent history of bacterial infection. The risk of long-term CVC infection was similar for tunneled catheters and venous access ports in each population.

Conclusions:

Prevention of long-term CVC infection should focus first on better sterile precautions while handling long-term CVC, especially in HIV patients who have frequent and daily use of the long-term CVC.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 20 , Issue 7 , July 1999 , pp. 494 - 498
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1999

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