A surveillance program for long-term central venous access-associated infections in outpatient chemotherapy services.
Infect Control Hosp Epidemiol
; 44(10): 1555-1561, 2023 10.
Article
en En
| MEDLINE
| ID: mdl-37039458
ABSTRACT
OBJECTIVE:
In this study, we described the first results of a surveillance system for infections associated with long-term central venous catheters (LT-CVC) in patients under outpatient chemotherapy.DESIGN:
This was a multicentric, prospective study.SETTING:
Outpatient chemotherapy services.PARTICIPANTS:
The study included 8 referral cancer centers in the State of São Paulo. INTERVENTION These services were invited to participate in a newly created surveillance program for patients under chemotherapy. Several meetings were convened to share previous experiences on LT-CVC infection surveillance and to define the surveillance method. Once the program was implemented, all bloodstream infection (LT-CVC BSIs), tunnel infection, and exit-site infections associated with LT-CVC were reported. Data from January to May 2021 were analyzed. The median monthly number of chemotherapy sessions per clinic was 925 (IQR, 270-5,855). We used Poisson regression to analyze the association of rates with the characteristics of the services.RESULTS:
In total, 107 LT-CVC infections were reported, of which 95% were BSIs, mostly associated with totally implantable devices (76%). Infections occurred a median of 4 days after the last catheter manipulation and 116 after the LT-CVC insertion. Also, 102 microorganisms were isolated from LT-CVC BSIs; the most common pathogen was Staphylococcus epidermidis, at 22%. Moreover, 44 infections (44%) fulfilled the criteria for CVC-related LT-CVC BSI and 27 infections (27%) met the criteria for mucosal barrier injury. The 1-year cumulative LT-CVC BSI rate was 1.94 per 1,000 CVC days of use. The rates were higher in public hospitals (IRR, 6.00; P < .001) and in hospitals that already had in place surveillance for LT-CVC infections (IRR, 2.01; P < .01).CONCLUSION:
Our study describes an applicable surveillance method for infections in cancer outpatients using LT-CVC.
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Cateterismo Venoso Central
/
Sepsis
/
Infecciones Relacionadas con Catéteres
/
Catéteres Venosos Centrales
Tipo de estudio:
Clinical_trials
/
Observational_studies
/
Risk_factors_studies
/
Screening_studies
Límite:
Humans
País como asunto:
America do sul
/
Brasil
Idioma:
En
Año:
2023
Tipo del documento:
Article