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1. Totally implantable central venous access ports in patients with cystic fibrosis: a multicenter prospective cohort study.

Author

Dal Molin A, Di Massimo DS, Braggion C, Bisogni S, Rizzi E, D'Orazio C, Di Toppa MV, Alghisi F, Cristadoro S, Carnovale V, Festa G, Rampini S, Colombo C, Oneta A, Furnari ML, Calamia MA, Zunino ML, Tuccio G, Spadea V, Messore B, Grosso B, and Festini F

Subjects
Adult, Catheter-Related Infections diagnosis, Cystic Fibrosis drug therapy, Equipment Design, Female, Humans, Incidence, Italy epidemiology, Male, Prospective Studies, Risk Assessment, Risk Factors, Time Factors, Upper Extremity Deep Vein Thrombosis diagnosis, Young Adult, Catheter Obstruction, Catheter-Related Infections epidemiology, Catheterization, Central Venous adverse effects, Catheterization, Central Venous instrumentation, Catheters, Indwelling, Central Venous Catheters, Cystic Fibrosis complications, Upper Extremity Deep Vein Thrombosis epidemiology
Abstract

Purpose: The aim of this study was to assess the incidence of late onset complications of totally implantable venous access devices (TIVAD) in patients with cystic fibrosis (CF) and to investigate possible associations between the rate of complications and different policies of TIVAD management., Methods: A multicenter prospective cohort study was performed in 11 Italian CF Centers. Patients with CF and a TIVAD were recruited and followed-up., Results: The study commenced on May 2008 and ended on September 2010. Eighty subjects were studied (77.5% women--mean age 27.2 years). Eighteen late complications of ports were observed (22.5%; incidence 0.96 per 1000 days of observation): three lumen occlusions, seven catheter-related infections , three port-related venous thrombosis, in addition to five other complications. A statistically significant association was found between the onset of catheter-related infection and the presence of CF-related diabetes (CFRD) (P=.0064), Conclusions: Our data suggest that TIVADs represent a safe and effective device for the intermittent IV administration of drugs in people with CF. However, people with CFRD have a higher risk of developing TIVAD-related infection.

Published
2012
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2. [Prevention and control of respiratory tract infections in the network of Italian Centers for Cystic Fibrosis].

Author

Festini F, Ballarin S, Loganes C, Codamo T, Doro R, Adamo A, Adorni R, Cucci M, Di Marco F, Lovallo R, Omenetti S, Panebianco R, Pisano G, Russo A, Sciabacucchi MC, and Zunino ML

Subjects
Adult, Air Microbiology, Child, Cystic Fibrosis therapy, Disinfectants administration & dosage, Hand Disinfection, Humans, Italy, Patient Isolation, Practice Guidelines as Topic, Respiratory Therapy, Respiratory Tract Infections microbiology, Surveys and Questionnaires, Cystic Fibrosis complications, Respiratory Tract Infections prevention & control
Abstract

Infections caused by respiratory pathogens such as Burkholderia cepacia and Pseudomonas aeruginosa are associated with an increased morbidity and mortality in people affected by cystic fibrosis, the most common lethal genetic disease in Caucasian populations. Preventing the acquisition of these pathogens is paramount for these patients. The goal of this survey was to assess the distribution and the prevalence of the measures adopted for the prevention and control of infections caused by respiratory pathogens in the 28 italian centres for cystic fibrosis. 21 questionnaires were returned and some important differences can be observed in the adoption of segregation measures. Although results may be influenced by other factors, specific segregation policies appear to be more directly associated than other measures (e.g., intensive disinfection; behavioural rules to minimise patient' contacts) with lower prevalence of Pseudomonas aeruginosa (OR 0.36 CI95% 0.31-0.42), of multidrug-resistant Pseudomonas aeruginosa (OR 0.30 CI95% 0.22-0.40), and of methicillin-resistant Staphylococcus aureus (OR 0.67 CI95% 0.48-0.94).

Published
2004

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