Cure of implantable venous port-associated bloodstream infections in pediatric hematology-oncology patients without catheter removal

Clin Infect Dis. 1999 Jul;29(1):102-5. doi: 10.1086/520135.

Abstract

The efficacy of antibiotic treatment of port-associated bloodstream infection without device removal has not been systematically studied. We analyzed the outcome of 43 consecutive port-associated bloodstream infections in pediatric hematology-oncology patients. Etiologies included Staphylococcus epidermidis (30) and Staphylococcus aureus (6). Antibiotics were given through the port for a median of 11 days. Four ports were removed within 72 hours. In 36 (92%) of the remaining 39 episodes, there was a response to antibiotic therapy (defervescence and negative blood culture). In 78% of episodes in which there was a response (excluding two in which the catheters were removed because of mechanical problems), the infections were cured without port removal. Two of the four relapses were cured with a second course of antibiotics. The cure rate was 92% for S. epidermidis infections and 67% for S. aureus infections. Thus, the majority of port-associated bloodstream infections in pediatric hematology-oncology patients can be cured without device removal.

MeSH terms

  • Bacteremia / drug therapy*
  • Bacteremia / microbiology
  • Candidiasis / drug therapy
  • Catheters, Indwelling / adverse effects*
  • Child, Preschool
  • Escherichia coli
  • Escherichia coli Infections / drug therapy
  • Escherichia coli Infections / etiology
  • Fungemia / drug therapy*
  • Fungemia / microbiology
  • Hematologic Diseases / complications
  • Humans
  • Klebsiella Infections / drug therapy
  • Klebsiella Infections / etiology
  • Klebsiella pneumoniae
  • Neoplasms / complications
  • Staphylococcal Infections / drug therapy
  • Staphylococcal Infections / etiology
  • Staphylococcus aureus
  • Staphylococcus epidermidis
  • Streptococcal Infections / drug therapy
  • Streptococcal Infections / etiology
  • Streptococcus sanguis
  • Treatment Outcome