MANAGEMENT OF SEPTIC COMPLICATIONS ASSOCIATED WITH SILASTIC CATHETERS IN CHILDHOOD MALIGNANCY
- 1 November 1987
- journal article
- research article
- Vol. 6 (11) , 1042-1047
Abstract
From January, 1979, to December, 1984, 63 Hickman or Broviac catheters were inserted into 50 high risk pediatric oncology patients (median age, 37 months). Catheters remained in place for an average of 241 days. Possible catheter sepsis and exit site infection accounted for the majority of (39 of 76) of the complications of long term central venous catheterization. Neurtropenia (absolute neutrophil count under 500/mm3) was associated with 70% of the catheter-related infections and 75% of the non-catheter-related infections. Catheters inserted during neutropenic episodes (23) were associated with an increased risk of subsequent septicemia (60% vs. 25%), a finding apparently related to their exposure to further neutropenia (38% vs. 16% catheter days). Of the 32 episodes of septicemia of unknown origin, 19 involved Gram-negative bacteria, 14 involved Gram-positive bacteria and 4 were caused by fungi. Five of these episodes involved multiple organisms. Staphylococcus epidermidis was the most common Gram-positive organism isolated (7 of 14). Four episodes of septicemia resolved before therapy and are considered false positive cultures. Of the other 28 episodes of septicemia, 25 (89%) were successfully treated without catheter removal including 3 episodes of fungemia and 4 of multiple organism sepsis. These data demonstrate the efficacy of antimicrobial treatment without catheter removal in the pediatric oncology population with catheter-associated infections including those associated with neutropenia, multiple organisms and fungemia.This publication has 13 references indexed in Scilit:
- Problems associated with indwelling central venous catheters.Archives of Disease in Childhood, 1985
- Paroxysmal Supraventricular TachycardiaAmerican Journal of Diseases of Children, 1984
- Quantitative blood cultures in the evaluation of septicemia in children with Broviac cathetersThe Journal of Pediatrics, 1984
- Occlusion and infection in broviac catheters during intensive cancer therapyCancer, 1983
- A prospective study of prolonged central venous access in leukemiaJAMA, 1982
- Broviac Catheter-Related Bacteremia in Oncology PatientsArchives of Pediatrics & Adolescent Medicine, 1982
- Septicemia in Childhood MalignancyClinical Pediatrics, 1981
- Infectious complications in the child with cancer. I. Pathophysiology of the compromised host and the initial evaluation and management of the febrile cancer patientThe Journal of Pediatrics, 1981
- INFECTIOUS COMPLICATIONS OF RIGHT ATRIAL CATHETERS USED FOR VENOUS ACCESS IN PATIENTS RECEIVING INTENSIVE CHEMOTHERAPY1981
- Expanded Applications of Broviac CatheterArchives of Surgery, 1980