438. Clinical outcome of catheter-salvage in neutropenic cancer patients with catheter-related infection
Session: Poster Session: Hospital-acquired and Transplant Infections
Friday, October 30, 2009: 12:00 AM
Room: Poster Hall A
Background: Catheter-related infection (CRI) causes 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 CRIs 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 Jan 1996 to Jun 2007. The outcome of initial catheter-salvage attempts was evaluated
Results: During the study period, a total of 51 neutropenic cancer patients with CRI were identified, and 53 organisms were isolated from culture specimens. The mean (± SD) patient age was 50 (± 14.8) years and the most common underlying disease was lymphoma (n=27, 53%). Among patients with CRI, 11 patients had exit-site infection, 3 had tunnel infection, 5 had catheter-related bloodstream infection (BSI), and 31 had catheter-associated BSI. 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 was successful. A univariate analysis showed that male gender and gram-negative pathogens were associated with failure of catheter-salvage. The overall mortality rate of febrile neutropenic cancer patients with CRI was 2% (1/51), which was lower than that of all febrile neutropenic cancer patients (75/924, 11%) and that in febrile neutropenic patients with MDI (34/208, 16.3%)(All P < 0.05).
Conclusion: In the current study including neutropenic cancer patients with CRI, the overall success rate of catheter-salvage attempts was 52.6% and the failure rate of catheter-salvage was significantly higher in CRI caused by gram-negative pathogen than in that by gram-positive pathogens. Our data suggest that catheter-salvage might not be a treatment option for neutropenic cancer patients with CRI caused by gram-negative bacteria, even though catheter-salvage should be attempted with a precaution for cancer patients with CRI.
Doo Ryeon Chung, MD1, Eun Jeong Joo, MD2, Cheol-In Kang, MD, PhD3, Joung A Lee, MD4, Kyong Ran Peck, MD, PhD, Jae-Hoon Song, MD1 and  E. Joo, None..
J. Lee, None..
C. Kang, None..
D. Chung, None..
K. Peck, None..
J. Song, None., (1)Division of Infectious Diseases, Samsung Medical Center, Seoul, South Korea, (2)Division of infectious disease, Samsung Medical Center, Seoul, Korea, Republic of, (3)Division of infectious disease, Samsung medical center, Seoul, Korea, Republic of, (4)Division of Infectious disease, Samsung medical center, Seoul, Korea, Republic of