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Impact of Central Venous Catheter Removal on the Recurrence of Catheter-Related Coagulase-Negative Stahylococcal Bacteremia

Published online by Cambridge University Press:  21 June 2016

Issam Raad ,
Steve Davis ,
Asma Khan ,
Jeffrey Tarrand ,
Linda Elting  and
Gerald P. Bodey
Issam Raad*
Affiliation:
Section of Infectious Diseases, Department of Medical Specialties, The University of Texas MD Anderson Cancer Center, Houston, Texas
Steve Davis
Affiliation:
Section of Infectious Diseases, Department of Medical Specialties, The University of Texas MD Anderson Cancer Center, Houston, Texas
Asma Khan
Affiliation:
Section of Infectious Diseases, Department of Medical Specialties, The University of Texas MD Anderson Cancer Center, Houston, Texas
Jeffrey Tarrand
Affiliation:
Section of Infectious Diseases, Department of Medical Specialties, The University of Texas MD Anderson Cancer Center, Houston, Texas
Linda Elting
Affiliation:
Section of Infectious Diseases, Department of Medical Specialties, The University of Texas MD Anderson Cancer Center, Houston, Texas
Gerald P. Bodey
Affiliation:
Section of Infectious Diseases, Department of Medical Specialties, The University of Texas MD Anderson Cancer Center, Houston, Texas
*
Section of Infectious Diseases (Box 47), UT MD Anderson Cancer Center, 1515 Holcombe Blvd., Houston, TX 77030
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Abstract

Objective:

To determine the impact of catheter management on the acute and long-term outcome of catheter-related coagulase-negative staphylococcal bacteremia.

Design:

Retrospective surveillance of catheter-related sepsis using quantitative blood and catheter cultures.

Setting:

University-affiliated tertiary cancer center.

Patients and Methods:

seventy patients with catheter-related coagulase-negative staphylococcal bacteremia were studied by retrospective chart review. The clinical characteristics of the patients and the management of the bacteremias were determined. The impact of immuno-suppressive risk factors, antibiotic therapy, and catheter management on the recurrence of the bacteremia was investigated.

Results:

Acute sepsis-related morbidity and mortality were not related to catheter management. However, during a 12-week followup period, the bacteremia recurred in 20% of the patients whose catheters remained in place, compared with only 3% of those whose catheters were removed (p<.05). By multivariate analysis, patients whose catheters remained in place were 2.9 times more likely to experience a recurrence than those whose catheters were removed (odds ratio = 2.9, 95% confidence interval = 1.2-8.8, p= .03). All other potential risk factors were equally distributed between patients, with and without a recurrence.

Conclusions:

Although patients with catheter-related coagulase-negative staphylococcal bacteremia could be treated successfully while the catheter remains in place with the majority remaining free of recurrence, catheter retention results in a significantly higher risk for the recurrence of the bacteremia.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 13 , Issue 4 , April 1992 , pp. 215 - 221
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1992

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