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Venous access port--related bacteremia in patients with acquired immunodeficiency syndrome or cancer: the reservoir as a diagnostic and therapeutic tool.

Abstract
To describe the rate of response to an antibiotic-lock technique (ALT) in the treatment of venous access port (VAP)--related bacteremia and to analyze the role of the reservoir in the persistence of infection, we reported the data from 12 human immunodeficiency virus--infected and 8 oncologic patients with VAP-related bacteremia. The ALT consisted of intracatheter delivery of antibiotics and was associated with a systemic antibiotic infusion. We monitored clinical manifestations and performed qualitative and quantitative blood cultures during and at the end of the treatment. Four patients had catheters removed before antibiotic treatment. Of the 16 patients who were treated with the ALT, 5 (31%) were cured, as determined by negative cultures of blood and of samples from the catheter; 2 (12.5%) were cured but had recurrent infection with another microorganism; and 9 (56%) had persistent positive cultures of blood and of samples from the tip, reservoir, or both of the VAP. Limited efficacy of the ALT might be explained by the presence of deposits of fibrin that include clusters of bacteria inside the reservoir of the port.
AuthorsP Longuet, M C Douard, G Arlet, J M Molina, C Benoit, C Leport
JournalClinical infectious diseases : an official publication of the Infectious Diseases Society of America (Clin Infect Dis) Vol. 32 Issue 12 Pg. 1776-83 (Jun 15 2001) ISSN: 1058-4838 [Print] United States
PMID11360220 (Publication Type: Journal Article)
Chemical References
  • Anti-Bacterial Agents
Topics
  • AIDS-Related Opportunistic Infections (diagnosis, drug therapy)
  • Adult
  • Anti-Bacterial Agents (therapeutic use)
  • Bacteremia (complications, diagnosis, drug therapy)
  • Breast Neoplasms (complications)
  • Catheterization, Central Venous (adverse effects)
  • Catheters, Indwelling (adverse effects)
  • Female
  • Humans
  • Lung Neoplasms (complications)
  • Lymphoma (complications)
  • Male
  • Neoplasms (complications, microbiology)
  • Pilot Projects
  • Staphylococcal Infections (diagnosis, drug therapy, microbiology)
  • Staphylococcus aureus (isolation & purification)
  • Staphylococcus epidermidis (isolation & purification)

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