Delay before implanting a port-a-cath after removing the previous one because of infection

Med Mal Infect. 2014 Jul;44(7):315-20. doi: 10.1016/j.medmal.2014.06.003. Epub 2014 Jul 10.

Abstract

Aims: We had for objective to assess the risk of a new Port-a-Cath (PAC) infection after re-implantation when the first one had been removed because of infection in the previous month.

Methods: We conducted a retrospective bicentric study including all patients having undergone PAC removal because of infection, followed by re-implantation of a new one in the next month, between 2004 and 2012.

Result: One hundred and forty-nine PAC removals were followed by re-implantation in the next month. The cause of removal was infection for 63 patients: 34 presented with bacteremia (13 PAC removals and simultaneous re-implantation, and 21 with delayed re-implantation for a mean 14days) and 29 presented with local signs of infection (20 PAC removals and simultaneous re-implantation, and with delayed re-implantation for a mean 13days). Two out of 13 PACs were re-infected in the bacteremia group, (15.4%) when the removal and re-implantation were performed simultaneously, and 1 out of 21 (4.8%) when re-implantation of the second PAC was delayed. The 3 re-infected PACs were successfully treated with antibiotics.

Conclusion: The early re-implantation of a PAC after removal of the previous one because of infection is a relatively safe procedure. The risk of infection can be higher when PAC removal and re-implantation are performed simultaneously in patients presenting with bacteremia; nevertheless, all reinfections were successfully treated with antibiotics.

Keywords: Catheters; Cathéters; Chambre implantable; Implantable venous access device; Infection.

Publication types

  • Multicenter Study

MeSH terms

  • Abscess / etiology
  • Bacteremia / epidemiology
  • Bacteremia / etiology*
  • Bacteremia / microbiology
  • Bacteremia / prevention & control
  • Catheter-Related Infections / epidemiology
  • Catheter-Related Infections / etiology*
  • Catheter-Related Infections / microbiology
  • Catheter-Related Infections / prevention & control
  • Catheter-Related Infections / therapy
  • Catheterization, Central Venous / methods*
  • Cross Infection / epidemiology
  • Cross Infection / etiology*
  • Cross Infection / microbiology
  • Cross Infection / prevention & control
  • Device Removal
  • Fever / etiology
  • France / epidemiology
  • Hospital Departments
  • Hospitals, Teaching / statistics & numerical data
  • Humans
  • Recurrence
  • Retrospective Studies
  • Staphylococcal Infections / epidemiology
  • Staphylococcal Infections / etiology
  • Staphylococcal Infections / prevention & control
  • Time Factors
  • Vascular Access Devices* / adverse effects