Factors influencing catheter-related infections in the Dutch multicenter study on high-dose chemotherapy followed by peripheral SCT in high-risk breast cancer patients.

Abstract

Neutropenia following high-dose chemotherapy leads to a high incidence of infectious complications, of which central venous catheter-related infections predominate. Catheter-related infections and associated risk factors in 392 patients participating in a randomized adjuvant breast cancer trial and assigned to receive high-dose chemotherapy and peripheral stem-cell reinfusion were evaluated. Median catheter dwell time was 25 days (range 1-141). Catheter-related infections were seen in 28.3% of patients (11 infections per 1000 catheter-days). Coagulase-negative staphylococci were found in 104 of 186 positive blood cultures (56%). No systemic fungal infections occurred. Cox regression analysis showed that duration of neutropenia >10 days (P=0.04), using the catheter for both stem-cell apheresis and high-dose chemotherapy (P= <0.01), and use of total parenteral nutrition (TPN, P=0.04) were predictive for catheter-related infections. In conclusion, a high incidence of catheter-related infections after high-dose chemotherapy was seen related to duration of neutropenia, use of the catheter for both stem-cell apheresis and high-dose chemotherapy, and use of TPN. Selective use and choice of catheters could lead to a substantial reduction of catheter-related infectious complications.

• Authors: P Nieboer, E G E de Vries, N H Mulder, S Rodenhuis, M Bontenbal, E van der Wall, Q G van Hoesel, W M Smit, P Hupperets, E E Voest, M A Nooij, H M Boezen, W T A van der Graaf
• Journal: Bone marrow transplantation (Bone Marrow Transplant) Vol. 42 Issue 7 Pg. 475-81 (Oct 2008) ISSN: 0268-3369 [Print] England
• PMID: 18622420 (Publication Type: Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)

Chemical References

• Antineoplastic Agents

Topics

• Antineoplastic Agents (administration & dosage, therapeutic use)
• Breast Neoplasms (complications, drug therapy, surgery)
• Catheterization (adverse effects)
• Catheters, Indwelling (adverse effects)
• Combined Modality Therapy (adverse effects)
• Female
• Humans
• Infections (epidemiology, etiology)
• Netherlands
• Neutropenia (etiology)
• Parenteral Nutrition, Total (adverse effects)
• Peripheral Blood Stem Cell Transplantation (adverse effects)
• Predictive Value of Tests
• Randomized Controlled Trials as Topic
• Time Factors