1. Incidence of sepsis in central venous catheter-bearing patients with hematologic malignancies: preliminary results
- Author
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Denis Ciapanna, M. Anghilieri, C. Lucchesini, S. Miqueleiz, E. Mazza, Erica Ravelli, Michele Nichelatti, Paola Cozzi, Guido Nador, A. De Gasperi, Valentina Mancini, C. Baraté, Annamaria Nosari, L. Bettinelli, Enrica Morra, and Francesca Ricci
- Subjects
medicine.medical_specialty ,Acute leukemia ,Chemotherapy ,business.industry ,medicine.medical_treatment ,030232 urology & nephrology ,Myeloid leukemia ,030204 cardiovascular system & hematology ,Neutropenia ,medicine.disease ,Gastroenterology ,Thrombosis ,Surgery ,Sepsis ,03 medical and health sciences ,Leukemia ,0302 clinical medicine ,Nephrology ,Internal medicine ,medicine ,business ,Central venous catheter - Abstract
Background Indwelling central venous catheters (CVCs) are essential devices in the management of patients with hematological disorders treated with chemotherapy. However, their nature predisposes patients to unwanted complications. Methods CVC-related complications were retrospectively analyzed in 227 hematologic patients who were consecutively admitted to our hematology department between May 2002 and April 2004. Patients’ diagnoses comprised acute myeloid leukemia (36.8%), acute lymphoid leukemia (7.3%), lymphoproliferative disorders (28.3%), multiple myeloma (19.5%), myeloproliferative syndromes (5%) and others (3.1%). The CVCs used were polyurethane three lumen 7-Fr (111 patients) for chemotherapy and 12-Fr (114 patients) for chemotherapy and peripheral blood stem cell apheresis, plus two tunneled catheters. Results The pathological events were: bacteriaemias (n=46); occlusions (n=10); exit tunnel infections (n=8); thrombosis (n=6); lung emboli (n=2). Among febrile patients the bacteriemia frequency was 20%, of which 13.6% were CVC-related (with a higher incidence in leukemia patients (p=0.027). Among the isolates, gram-positive bacteria were found in 29 cases (23 CVC-related cases), and gram-negative bacteria in 16 cases (8 CVC-related cases). Only one patient had Candida albicans sepsis. At univariate and multivariate analysis significant risk factors for infection (pConclusions In our hematologic patients, the CVC complications were mainly septic, with only 10.1% of CVC-related bacteriemias, despite prolonged catheterization duration. Acute leukemia patients were at major risk for sepsis, probably due to a more severe neutropenia and prolonged catheterization duration.
- Published
- 2006