Factors influencing catheter-related infections in the Dutch multicenter study on high-dose chemotherapy followed by peripheral SCT in high-risk breast cancer patients.

Abstract:

:Neutropenia following high-dose chemotherapy leads to a high incidence of infectious complications, of which central venous catheter-related infections predominate. Catheter-related infections and associated risk factors in 392 patients participating in a randomized adjuvant breast cancer trial and assigned to receive high-dose chemotherapy and peripheral stem-cell reinfusion were evaluated. Median catheter dwell time was 25 days (range 1-141). Catheter-related infections were seen in 28.3% of patients (11 infections per 1000 catheter-days). Coagulase-negative staphylococci were found in 104 of 186 positive blood cultures (56%). No systemic fungal infections occurred. Cox regression analysis showed that duration of neutropenia >10 days (P=0.04), using the catheter for both stem-cell apheresis and high-dose chemotherapy (P= <0.01), and use of total parenteral nutrition (TPN, P=0.04) were predictive for catheter-related infections. In conclusion, a high incidence of catheter-related infections after high-dose chemotherapy was seen related to duration of neutropenia, use of the catheter for both stem-cell apheresis and high-dose chemotherapy, and use of TPN. Selective use and choice of catheters could lead to a substantial reduction of catheter-related infectious complications.

journal_name

Bone Marrow Transplant

authors

Nieboer P,de Vries EG,Mulder NH,Rodenhuis S,Bontenbal M,van der Wall E,van Hoesel QG,Smit WM,Hupperets P,Voest EE,Nooij MA,Boezen HM,van der Graaf WT

doi

10.1038/bmt.2008.195

subject

Has Abstract

pub_date

2008-10-01 00:00:00

pages

475-81

issue

7

eissn

0268-3369

issn

1476-5365

pii

bmt2008195

journal_volume

42

pub_type

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