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Outcomes of Hickman Catheter Salvage in Febrile Neutropenic Cancer Patients With Staphylococcus aureus Bacteremia

Published online by Cambridge University Press:  02 January 2015

Sung-Han Kim ,
Cheol-In Kang ,
Hong-Bin Kim ,
Sung-Soo Youn ,
Myoung-don Oh ,
Eui-Chong Kim ,
Seon-Yang Park ,
Byoung-Kook Kim  and
Kang-Won Choe
Sung-Han Kim
Affiliation:
Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
Cheol-In Kang
Affiliation:
Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
Hong-Bin Kim
Affiliation:
Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
Sung-Soo Youn
Affiliation:
Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
Myoung-don Oh*
Affiliation:
Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea Clinical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea
Eui-Chong Kim
Affiliation:
Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea Clinical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea
Seon-Yang Park
Affiliation:
Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
Byoung-Kook Kim
Affiliation:
Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
Kang-Won Choe
Affiliation:
Clinical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea
*
Department of Internal Medicine, Seoul National University Hospital, 28 Youngun-dong, Chongro-gu, Seoul, Republic of Korea, 110-744
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Abstract

Objective:

To evaluate the outcome of attempted Hickman catheter salvage in neutropenic cancer patients with Staphylococcus aureus bacteremia who were not using antibiotic lock therapy.

Design:

Retrospective cohort study.

Setting:

A university-affiliated, tertiary-care hospital with 1,500 beds for adult patients.

Patients:

All neutropenic cancer patients who had a Hickman catheter andS. aureus bacteremia (32 episodes in 29 patients) between January 1998 and March 2002.

Methods:

Salvage attempts were defined as cases where the Hickman catheter was not removed until we obtained the results of follow-up blood cultures performed 48 to 72 hours after starting treatment with antistaphylococcal antibiotics. Salvage was considered to be successful if the Hickman catheter was still in place 3 months later without recurrent bacteremia or death.

Results:

Catheter salvage was attempted in 24 (75%) of the 32 episodes. Of the salvage attempts, the success rate was 50% (12 of 24). Salvage attempts were successful in 14% (1 of 7) of the episodes with positive follow-up blood cultures, and in 65% (11 of 17) of those with negative follow-up blood cultures (P = .07). If the analysis is confined to cases with no external signs of catheter infection, salvage attempts were successful in 14% (1 of 7) of the episodes with positive follow-up blood cultures and in 80% (8 of 10) of those with negative follow-up blood cultures (P = .02).

Conclusion:

In neutropenic cancer patients with S. aureus bacteremia, attempted catheter salvage without antibiotic lock therapy was successful in 50% of the cases.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 24 , Issue 12 , December 2003 , pp. 897 - 904
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2003 

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