Long-term central venous access vs other home therapies: Complications in patients with acquired immunodeficiency syndrome

L. Mukau, M. A. Talamini, J. V. Sitzmann, R. C. Burns, M. E. McGuire

Research output: Contribution to journalArticle

Abstract

One hundred and forty silicone catheters were inserted in 127 patients for long-term intravenous access with a cumulative follow-up time of 21,125 catheter-days (58 patient-years). Fifty-six patients had acquired immunodeficiency syndrome (AIDS); 44 were not AIDS patients and were receiving ambulatory home parenteral nutrition, whereas the remaining 27 did not have AIDS and were receiving home antibiotic therapy. Patients had a mean of 1.1 catheters inserted, and the rate of Hickman catheter-related sepsis was 0.18 per 100 catheter days or 0.6 septic episodes per patient year of treatment. Catheter-related sepsis was higher in AIDS patients (p <.01) and in patients receiving parenteral nutrition (p <.05) compared with those receiving antibiotic therapy. Prior catheter infection and AIDS were the most significant predictors of catheter infection (p <.01). Staphylococcus aureus was the most commonly isolated pathogen (61%) in AIDS patients. Fever (p <.001) and relative leukocytosis (p <.02) were the most common signs of infection. Only 14 infected catheters (37.8%) were salvaged by antibiotic therapy after the initial infection episode, and 6 of these catheters (42.9%) had recurrent multiple infections. In addition, inflammatory bowel disease was found to be a risk factor for venous thrombosis (p = .018). We conclude that because immunocompromised patients have a high risk of infection, catheter-related sepsis in these patients should be treated by catheter removal and antibiotics.

Original languageEnglish (US)
Pages (from-to)455-459
Number of pages5
JournalJournal of Parenteral and Enteral Nutrition
Volume16
Issue number5
Publication statusPublished - 1992

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ASJC Scopus subject areas

  • Food Science
  • Medicine (miscellaneous)

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