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
StatePublished - 1992

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acquired immunodeficiency syndrome
catheters
Acquired Immunodeficiency Syndrome
Catheters
therapeutics
sepsis (infection)
Therapeutics
antibiotics
Anti-Bacterial Agents
infection
Infection
Sepsis
parenteral feeding
Home Parenteral Nutrition
Catheter-Related Infections
Leukocytosis
Parenteral Nutrition
Immunocompromised Host
silicone
Silicones

ASJC Scopus subject areas

  • Food Science
  • Medicine (miscellaneous)

Cite this

Long-term central venous access vs other home therapies : Complications in patients with acquired immunodeficiency syndrome. / Mukau, L.; Talamini, M. A.; Sitzmann, J. V.; Burns, R. C.; McGuire, M. E.

In: Journal of Parenteral and Enteral Nutrition, Vol. 16, No. 5, 1992, p. 455-459.

Research output: Contribution to journalArticle

Mukau, L. ; Talamini, M. A. ; Sitzmann, J. V. ; Burns, R. C. ; McGuire, M. E. / Long-term central venous access vs other home therapies : Complications in patients with acquired immunodeficiency syndrome. In: Journal of Parenteral and Enteral Nutrition. 1992 ; Vol. 16, No. 5. pp. 455-459.
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