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Infectious complications of radiologically placed upper arm ports: A single center analysis.

Authors :
Koehler D
Haus JM
Shenas F
Rohde H
Ittrich H
Adam G
Peldschus K
Source :
PloS one [PLoS One] 2023 Apr 13; Vol. 18 (4), pp. e0284475. Date of Electronic Publication: 2023 Apr 13 (Print Publication: 2023).
Publication Year :
2023

Abstract

Objectives: Infections are common complications in venous access ports. The presented analysis aimed to investigate the incidence, microbiological spectrum, and acquired resistances of pathogens in upper arm port associated infections to provide a decision aid in the choice of therapy.<br />Materials and Methods: In total, 2667 implantations and 608 explantations were performed at a high-volume tertiary medical center between 2015 and 2019. In cases with infectious complications (n = 131, 4.9%), procedural conditions and results of microbiological testing were reviewed retrospectively.<br />Results: Of 131 port associated infections (median dwell time 103 days, interquartile range 41-260), 49 (37.4%) were port pocket infections (PPI) and 82 (62.6%) were catheter infections (CI). Infectious complications occurred more often after implantation in inpatients compared to outpatients (P < 0.01). PPI were mainly caused by Staphylococcus aureus (S. aureus, 48.3%) and coagulase-negative staphylococci (CoNS, 31.0%). Other gram-positive and gram-negative species were encountered in 13.8% and 6.9%, respectively. CI were caused less frequently by S. aureus (8.6%) than CoNS (39.7%). Other gram-positive and gram-negative strains were isolated in 8.6% and 31.0%, respectively. Candida species were seen in 12.1% of CI. An acquired antibiotic resistance was detected in 36.0% of all significant isolates, occurring especially in CoNS (68.3%) and gram-negative species (24.0%).<br />Conclusions: Staphylococci comprised the largest group of pathogens in upper arm port associated infections. However, gram-negative strains and Candida species should also be considered as a cause of infection in CI. Due to the frequent detection of potential biofilm-forming pathogens, port explantation is an important therapeutic measure, especially in severely ill patients. Acquired resistances must be anticipated when choosing an empiric antibiotic treatment.<br />Competing Interests: I have read the journal’s policy and the authors of this manuscript have the following competing interests: Holger Rohde received personal fees from Pfizer Pharma, from MSD, from Infectopharm, from Correvio, and from Shionogie outside the submitted work. The other authors have declared that no competing interests exist. This does not alter our adherence to PLOS ONE policies on sharing data and materials.<br /> (Copyright: © 2023 Koehler et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Details

Language :
English
ISSN :
1932-6203
Volume :
18
Issue :
4
Database :
MEDLINE
Journal :
PloS one
Publication Type :
Academic Journal
Accession number :
37053295
Full Text :
https://doi.org/10.1371/journal.pone.0284475