A Case-Control Study to Identify Risk Factors for Totally Implantable Central Venous Port-Related Bloodstream Infection

作者：Lee Guk Jin; Hong Sook Hee; Roh Sang Young; Park Sa Rah; Lee Myung Ah; Chun Hoo Geun; Hong Young Seon; Kang Jin Hyoung^*; Kim Sang Il; Kim Youn Jeong; Chun Ho Jong; Oh Jung Suk

来源：Cancer Research and Treatment, 2014, 46(3): 250-260.

DOI：10.4143/crt.2014.46.3.250

• Neoplasms
• Catheter-related infections
• Risk factors

Purpose %26lt;br%26gt;To date, the risk factors for central venous port-related bloodstream infection (CVP-BSI) in solid cancer patients have not been fully elucidated. We conducted this study in order to determine the risk factors for CVP-BSI in patients with solid cancer. %26lt;br%26gt;Materials and Methods %26lt;br%26gt;A total of 1,642 patients with solid cancer received an implantable central venous port for delivery of chemotherapy between October 2008 and December 2011 in a single center. CVP-BSI was diagnosed in 66 patients (4%). We selected a control group of 130 patients, who were individually matched with respect to age, sex, and catheter insertion time. %26lt;br%26gt;Results %26lt;br%26gt;CVP-BSI occurred most frequently between September and November (37.9%). The most common pathogen was gram-positive cocci (n=35, 53.0%), followed by fungus (n=14, 21.2%). Multivariate analysis identified monthly catheter-stay as a risk factor for CVP-BSI (p=0.000), however, its risk was lower in primary gastrointestinal cancer than in other cancer (p=0.002). Initial metastatic disease and long catheter-stay were statistically significant factors affecting catheter life span (p=0.005 and p=0.000). Results of multivariate analysis showed that recent transfusion was a risk factor for mortality in patients with CVP-BSI (p=0.047). %26lt;br%26gt;Conclusion %26lt;br%26gt;In analysis of the results with respect to risk factors, prolonged catheter-stay should be avoided as much as possible. It is necessary to be cautious of CVP-BSI in metastatic solid cancer, especially non-gastrointestinal cancer. In addition, avoidance of unnecessary transfusion is essential in order to reduce the mortality of CVP-BSI. Finally, considering the fact that confounding factors may have affected the results, conduct of a well-designed prospective controlled study is warranted.

• 出版日期2014-7