Methods: A retrospective audit was carried out on CVAD insertions (tunnelled central venous catheter (CVC) or subcutaneous port) by the Vascular Surgery and Radiology Departments at a tertiary teaching hospital in Sydney, Australia from January 2014 to December 2016. Data were collected on patient demographics, antibiotic prophylaxis, skin preparation and CRIs. Rates of CRIs were compared by Chi-Square test (α 0.05).
Results: 95 (11 tunnelled CVC; 84 subcutaneous ports) and 222 (21 tunnelled CVC; 201 subcutaneous ports) CVAD insertions were performed by vascular surgery and radiology respectively. Median age was 56 years (IQR 48-66) in the vascular cohort and 64 years (IQR 55-72) in the radiology cohort. Females were predominant in both vascular (70; 73.7%) and radiology (119, 53.6%) cohorts and the most common indication was chemotherapy (vascular 84; 88.4% and radiology 205; 92.8% n=1 missing). Antibiotic prophylaxis was used in 88 (92.6%) vascular insertions but only 2 (0.95%; n=12 missing) insertions by radiology. Iodine skin preparation was preferred for vascular insertions (92; 98.9%, n=2 missing) compared to chlorhexidine for radiology insertions (214; 97.7%, n=3 missing). CRIs occurred in 4 (4.2%) of the vascular cohort and 8 (3.6%) of radiology cohort (P=0.80).
Conclusion: Rates of CRIs complicating CVAD procedures were similar in a vascular cohort where most received antibiotic prophylaxis, and in a radiology cohort where antibiotic prophylaxis was rarely used. There was no evidence to support antibiotic prophylaxis in prevention of CRIs, although choice of skin preparation and other factors may have confounded findings.
M. Anshaw, None
H. Chan, None
P. Konecny, None