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

Bone Marrow Transplant. 2008 Oct;42(7):475-81. doi: 10.1038/bmt.2008.195. Epub 2008 Jul 14.

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.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antineoplastic Agents / administration & dosage
  • Antineoplastic Agents / therapeutic use*
  • Breast Neoplasms / complications
  • Breast Neoplasms / drug therapy*
  • Breast Neoplasms / surgery
  • Catheterization / adverse effects*
  • Catheters, Indwelling / adverse effects*
  • Combined Modality Therapy / adverse effects*
  • Female
  • Humans
  • Infections / epidemiology
  • Infections / etiology*
  • Netherlands
  • Neutropenia / etiology
  • Parenteral Nutrition, Total / adverse effects*
  • Peripheral Blood Stem Cell Transplantation / adverse effects*
  • Predictive Value of Tests
  • Randomized Controlled Trials as Topic
  • Time Factors

Substances

  • Antineoplastic Agents