Changing Epidemiology of Catheter-Related Bloodstream Infections in Cancer Patients

2018 ◽  
Vol 39 (6) ◽  
pp. 727-729 ◽  
Author(s):  
Anne Marie Chaftari ◽  
Ray Hachem ◽  
Ying Jiang ◽  
Pankil Shah ◽  
Alawami Hussain ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Bloodstream Infections ◽  
Central Venous Catheters ◽  
Infect Control Hosp ◽  
Central Venous ◽  
Gram Negative ◽  
Gram Negative Organisms

We compared the etiologic organisms of bloodstream infections (BSIs) in cancer patients with central venous catheters (CVCs) between 2 cohorts separated by more than a decade.Gram-negative organisms have become the predominant etiologic organisms of BSIs (52%); they now contribute to 41% of catheter-related BSIs (CRBSIs).Infect Control Hosp Epidemiol 2018;39:727–729

Unnecessary Removal of Central Venous Catheters in Cancer Patients with Bloodstream Infections

2018 ◽  
Vol 39 (2) ◽  
pp. 222-225 ◽  
Author(s):  
Anne Marie Chaftari ◽  
Ray Hachem ◽  
Sammy Raad ◽  
Ying Jiang ◽  
Elizabeth Natividad ◽  
...  
Keyword(s):  
Central Venous Catheter ◽  
Cancer Patients ◽  
Vascular Access ◽  
Bloodstream Infections ◽  
Venous Catheter ◽  
Central Line ◽  
Central Venous Catheters ◽  
Infect Control Hosp ◽  
Physician Education ◽  
Central Venous

We evaluated the rate of central venous catheter (CVC) removal in 283 cancer patients with bloodstream infections (BSIs). Removal of CVCs occurred unnecessarily in 57% of patients with non-central-line-associated BSI (non-CLABSI), which was equivalent to the rate of CVC removal in patients with CLABSIs. Physician education and safe interventions to salvage the vascular access are warranted.Infect Control Hosp Epidemiol 2018;39:222–225

scholarly journals Impact of Catheter Management on Clinical Outcome in Adult Cancer Patients With Gram-Negative Bacteremia

2019 ◽  
Vol 6 (10) ◽  
Author(s):  
Johny Fares ◽  
Melissa Khalil ◽  
Anne-Marie Chaftari ◽  
Ray Hachem ◽  
Ying Jiang ◽  
...  
Keyword(s):  
Central Venous Catheter ◽  
Cancer Patients ◽  
Bloodstream Infection ◽  
Bloodstream Infections ◽  
Venous Catheter ◽  
Mucosal Barrier ◽  
Central Venous ◽  
Gram Negative ◽  
Central Venous Catheter Removal ◽  
Mucosal Barrier Injury

Abstract Objective Gram-negative organisms have become a major etiology of bloodstream infections. We evaluated the effect of central venous catheter management on cancer patients with gram-negative bloodstream infections. Method We retrospectively identified patients older than 14 years with central venous catheters who were diagnosed with gram-negative bloodstream infections to determine the effect of catheter management on outcome. Patients were divided into 3 groups: Group 1 included patients with central line-associated bloodstream infections (CLABSI) without mucosal barrier injury and those whose infection met the criteria for catheter-related bloodstream infection; group 2 included patients with CLABSI with mucosal barrier injury who did not meet the criteria for catheter-related bloodstream infection; and group 3 included patients with non-CLABSI. Results The study included 300 patients, with 100 patients in each group. Only in group 1 was central venous catheter removal within 2 days of bloodstream infection significantly associated with a higher rate of microbiologic resolution at 4 days compared to delayed central venous catheter removal (3–5 days) or retention (98% vs 82%, P = .006) and a lower overall mortality rate at 3-month follow-up (3% vs 19%, P = .01). Both associations persisted in multivariate analyses (P = .018 and P = .016, respectively). Conclusions Central venous catheter removal within 2 days of the onset of gram-negative bloodstream infections significantly improved the infectious outcome and overall mortality of adult cancer patients with catheter-related bloodstream infections and CLABSI without mucosal barrier injury.

Long-Term Silicone Central Venous Catheters Impregnated With Minocycline and Rifampin Decrease Rates of Catheter-Related Bloodstream Infection in Cancer Patients: A Prospective Randomized Clinical Trial

2004 ◽  
Vol 22 (15) ◽  
pp. 3163-3171 ◽  
Author(s):  
Hend Hanna ◽  
Robert Benjamin ◽  
Ioannis Chatzinikolaou ◽  
Badie Alakech ◽  
Deborah Richardson ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Cancer Patients ◽  
Bloodstream Infection ◽  
Tertiary Care ◽  
Bloodstream Infections ◽  
Central Venous Catheters ◽  
Care Hospital ◽  
Central Venous ◽  
Catheter Related Bloodstream Infection

PurposeTo evaluate the efficacy of long-term nontunneled silicone catheters impregnated with minocycline and rifampin (M-R) in reducing catheter-related bloodstream infections.Patients and MethodsThis prospective, randomized, double-blind clinical trial was conducted at M.D. Anderson Cancer Center, a tertiary care hospital in Houston, TX. All patients in the trial had a malignancy.ResultsBetween September 1999 and May 2002, 356 assessable catheters were used: 182 M-R and 174 nonimpregnated. The patients' characteristics were comparable between the two study groups. The mean (± standard deviation) duration of catheterization with M-R catheters was comparable to that of nonimpregnated catheters (66.21 ± 30.88 v 63.01 ± 30.80 days). A total of 17 catheter-related bloodstream infections occurred during the course of the study. Three were associated with the use of M-R catheters and 14 were associated with the nonimpregnated catheters, with a rate of catheter-related bloodstream infection of 0.25 and 1.28/1,000 catheter-days, respectively (P = .003). Gram-positive cocci accounted for the majority of the organisms causing the infections. There were no allergic reactions associated with M-R catheters.ConclusionLong-term nontunneled central venous catheters impregnated with minocycline and rifampin are efficacious and safe in reducing catheter-related bloodstream infections in cancer patients.

scholarly journals Unnecessary Removal of Central Venous Catheters in Cancer Patients with Bloodstream Infections: Impact on Symptom Burden

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S635-S635 ◽  
Author(s):  
Anne-Marie Chaftari ◽  
Sammy Raad ◽  
Ray Y Hachem ◽  
Pankil Shah ◽  
Ying Jiang ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Symptom Burden ◽  
Bloodstream Infections ◽  
Central Venous Catheters ◽  
Central Venous

Sources and outcome of bloodstream infections in cancer patients: the role of central venous catheters

2007 ◽  
Vol 26 (8) ◽  
pp. 549-556 ◽  
Author(s):  
I. Raad ◽  
R. Hachem ◽  
H. Hanna ◽  
P. Bahna ◽  
I. Chatzinikolaou ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Bloodstream Infections ◽  
Central Venous Catheters ◽  
Central Venous

Central Venous Catheter-Associated Bloodstream Infections in Pediatric Oncology Home Care

2002 ◽  
Vol 23 (2) ◽  
pp. 99-101 ◽  
Author(s):  
Samir S. Shah ◽  
Mary Lou Manning ◽  
Elizabeth Leahy ◽  
Mark Magnusson ◽  
Susan R. Rheingold ◽  
...  
Keyword(s):  
Home Care ◽  
Pediatric Oncology ◽  
Bloodstream Infections ◽  
Venous Catheter ◽  
Home Care Services ◽  
Central Venous Catheters ◽  
Central Venous ◽  
Oncology Patients ◽  
Care Services ◽  
Gram Negative Organisms

AbstractFifty-two pediatric oncology patients with central venous catheters (CVCs) who received home care services were studied. Gram-negative organisms were responsible for a greater proportion of CVC-associated bloodstream infections in pediatric oncology patients receiving home care than in hospitalized pediatric oncology patients.

scholarly journals Impact of Critical Care Consultation Requests for Avoidable Central Venous Catheters on Medical-Surgical Units

2020 ◽  
Vol 41 (S1) ◽  
pp. s258-s258
Author(s):  
Madhuri Tirumandas ◽  
Theresa Madaline ◽  
Gregory David Weston ◽  
Ruchika Jain ◽  
Jamie Figueredo
Keyword(s):  
Critical Care ◽  
High Risk ◽  
Medical Center ◽  
Academic Medical Center ◽  
Retrospective Chart Review ◽  
Bloodstream Infections ◽  
Central Line ◽  
Central Venous Catheters ◽  
High Risk Population ◽  
Central Venous

Background: Although central-line–associated bloodstream infections (CLABSI) in US hospitals have improved in the last decade, ~30,100 CLABSIs occur annually.1,2 Central venous catheters (CVC) carry a high risk of infections and should be limited to appropriate clinical indications.6,7 Montefiore Medical Center, a large, urban, academic medical center in the Bronx, serves a high-risk population with multiple comobidities.8–11 Despite this, the critical care medicine (CCM) team is often consulted to place a CVC when a peripheral intravenous line (PIV) cannot be obtained by nurses or primary providers. We evaluated the volume of CCM consultation requests for avoidable CVCs and related CLABSIs. Methods: Retrospective chart review was performed for patients with CCM consultation requests for CVC placement between July and October 2019. The indication for CVC, type of catheter inserted or recommended, and NHSN data were used to identify CLABSIs. CVCs were considered avoidable if a PIV was used for the stated indication and duration of therapy, with no anatomical contraindications to PIV in nonemergencies, according to the Michigan Appropriateness Guide for Intravenous Catheters (MAGIC).6Results: Of 229 total CCM consults, 4 (18%) requests were for CVC placement; 21 consultations (9%) were requested for avoidable CVCs. Of 40 CVC requests, 18 (45%) resulted in CVC placement by the CCM team, 4 (10%) were deferred for nonurgent PICC by interventional radiology, and 18 (45%) were deferred in favor of PIV or no IV. Indications for CVC insertion included emergent chemotherapy (n = 8, 44%) and dialysis (n = 3, 16%), vasopressors (n = 3, 16%), antibiotics (n = 2, 11%) and blood transfusion (n = 2, 11%). Of 18 CVCs, 9 (50%) were potentially avoidable: 2 short-term antibiotics and rest for nonemergent indications; 2 blood transfusions, 1 dialysis, 2 chemotherapy and 2 vasopressors. Between July and October 2019, 6 CLABSIs occurred in CVCs placed by the CCM team; in 3 of 6 CLABSI events (50%), the CVC was avoidable. Conclusions: More than half of consultation requests to the CCM team for CVCs are avoidable, and they disproportionately contribute to CLABSI events. Alternatives for intravenous access could potentially avoid 9% of CCM consultations and 50% of CLABSIs in CCM-inserted CVCs on medical-surgical wards.Funding: NoneDisclosures: None

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