Clinical outcome of catheter salvage in neutropenic cancer patients with catheter-related infection

Scand J Infect Dis. 2011 Apr;43(4):258-63. doi: 10.3109/00365548.2010.544669. Epub 2010 Dec 28.

Abstract

Background: Catheter-related infections (CRI) cause significant morbidity and mortality in cancer patients, particularly during episodes of chemotherapy-induced neutropenia. This study was performed to evaluate clinical features and outcomes of CRI in neutropenic cancer patients.

Methods: We retrospectively analyzed clinical characteristics and outcome of febrile neutropenic cancer patients with CRI who visited the emergency department from January 1996 to June 2007.

Results: A total of 51 neutropenic cancer patients with CRI were identified and 53 organisms were isolated from culture specimens. The mean ± standard deviation patient age was 50 ± 15 y and the most common underlying disease was lymphoma (n = 27, 53%). Gram-positive organisms accounted for 77% of all isolated pathogens (41/53). Initial catheter salvage was attempted in 38 episodes of CRI, of which 20 were successful. In the current study the overall success rate of catheter salvage attempts was 52.6%. The failure rate of catheter salvage was significantly higher in CRI caused by Gram-negative pathogens than by Gram-positive pathogens.

Conclusion: Although catheter salvage should be cautiously attempted for cancer patients with CRI, it might not be a treatment option for neutropenic cancer patients with CRI caused by Gram-negative bacteria.

MeSH terms

  • Adult
  • Aged
  • Bacteria / classification
  • Bacteria / isolation & purification
  • Bacterial Infections / microbiology
  • Bacterial Infections / pathology
  • Bacterial Infections / therapy
  • Catheter-Related Infections / pathology
  • Catheter-Related Infections / therapy*
  • Female
  • Fever of Unknown Origin / pathology
  • Fever of Unknown Origin / therapy*
  • Humans
  • Immunocompromised Host
  • Male
  • Middle Aged
  • Neoplasms / complications*
  • Neutropenia / therapy*
  • Retrospective Studies
  • Treatment Outcome