Article ; Online: A surveillance program for long-term central venous access-associated infections in outpatient chemotherapy services.
Infection control and hospital epidemiology
2023 Volume 44, Issue 10, Page(s) 1555–1561
Abstract: Objective: In this study, we described the first results of a surveillance system for infections associated with long-term central venous catheters (LT-CVC) in patients under outpatient chemotherapy.: Design: This was a multicentric, prospective ... ...
| Abstract | Objective: In this study, we described the first results of a surveillance system for infections associated with long-term central venous catheters (LT-CVC) in patients under outpatient chemotherapy. Design: This was a multicentric, prospective study. Setting: Outpatient chemotherapy services. Participants: The study included 8 referral cancer centers in the State of São Paulo. Intervention: These services were invited to participate in a newly created surveillance program for patients under chemotherapy. Several meetings were convened to share previous experiences on LT-CVC infection surveillance and to define the surveillance method. Once the program was implemented, all bloodstream infection (LT-CVC BSIs), tunnel infection, and exit-site infections associated with LT-CVC were reported. Data from January to May 2021 were analyzed. The median monthly number of chemotherapy sessions per clinic was 925 (IQR, 270-5,855). We used Poisson regression to analyze the association of rates with the characteristics of the services. Results: In total, 107 LT-CVC infections were reported, of which 95% were BSIs, mostly associated with totally implantable devices (76%). Infections occurred a median of 4 days after the last catheter manipulation and 116 after the LT-CVC insertion. Also, 102 microorganisms were isolated from LT-CVC BSIs; the most common pathogen was Staphylococcus epidermidis, at 22%. Moreover, 44 infections (44%) fulfilled the criteria for CVC-related LT-CVC BSI and 27 infections (27%) met the criteria for mucosal barrier injury. The 1-year cumulative LT-CVC BSI rate was 1.94 per 1,000 CVC days of use. The rates were higher in public hospitals (IRR, 6.00; P < .001) and in hospitals that already had in place surveillance for LT-CVC infections (IRR, 2.01; P < .01). Conclusion: Our study describes an applicable surveillance method for infections in cancer outpatients using LT-CVC. |
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| MeSH term(s) | Humans ; Brazil/epidemiology ; Catheter-Related Infections/epidemiology ; Catheter-Related Infections/etiology ; Catheterization, Central Venous/adverse effects ; Central Venous Catheters/adverse effects ; Outpatients ; Prospective Studies ; Sepsis/etiology | |||||
| Language | English | |||||
| Publishing date | 2023-04-11 | |||||
| Publishing country | United States | |||||
| Document type | Journal Article ; Multicenter Study | |||||
| ZDB-ID | 639378-0 | |||||
| ISSN | 1559-6834 ; 0195-9417 ; 0899-823X | |||||
| ISSN (online) | 1559-6834 | |||||
| ISSN | 0195-9417 ; 0899-823X | |||||
| DOI | 10.1017/ice.2023.13 | |||||
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| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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