A surveillance program for long-term central venous access-associated infections in outpatient chemotherapy services

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CARLESSE, Fabianne
BELIZARIO, Juliana De Cassia
GERMANO, Priscila Costa Pimentel
VIROLLI, Juliana Monteiro
TURDO, Anna Claudia
RODRIGUES, Beatriz Quental
MACIEL, Amanda Luiz Pires
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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 Sao 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.
  1. [Anonymous], CDC NHSN BLOODSTREAM
  2. Busch JD, 2012, AM J ROENTGENOL, V199, P447, DOI 10.2214/AJR.11.7970
  3. Chang TC, 2022, LANGENBECK ARCH SURG, V407, P343, DOI 10.1007/s00423-021-02328-0
  4. Chang YF, 2013, PALLIATIVE MED, V27, P185, DOI 10.1177/0269216311428777
  5. Gama ZAD, 2019, J INFECT PUBLIC HEAL, V12, P619, DOI 10.1016/j.jiph.2019.02.016
  6. Fares J, 2019, OPEN FORUM INFECT DI, V6, DOI 10.1093/ofid/ofz357
  7. Freire MP, 2018, ANTIMICROB AGENTS CH, V62, DOI [10.1128/AAC.00569-18, 10.1128/aac.00569-18]
  8. Freire MP, 2013, INFECT CONT HOSP EP, V34, P671, DOI 10.1086/671006
  9. Hsu JF, 2015, WORLD J SURG ONCOL, V13, DOI 10.1186/s12957-015-0707-2
  10. Jiang M, 2020, SUPPORT CARE CANCER, V28, P361, DOI 10.1007/s00520-019-04809-x
  11. Kato Y, 2018, J INFECT CHEMOTHER, V24, P31, DOI 10.1016/j.jiac.2017.08.013
  12. Lebeaux D, 2014, LANCET INFECT DIS, V14, P146, DOI 10.1016/S1473-3099(13)70266-4
  13. Lecronier M, 2018, ANN INTENSIVE CARE, V8, DOI 10.1186/s13613-018-0383-9
  14. Li, 2021, PLOS ONE, V16
  15. Magiorakos AP, 2012, CLIN MICROBIOL INFEC, V18, P268, DOI 10.1111/j.1469-0691.2011.03570.x
  16. Mermel LA, 2009, CLIN INFECT DIS, V49, P1, DOI 10.1086/599376
  17. Mollee P, 2020, J HOSP INFECT, V106, P335, DOI 10.1016/j.jhin.2020.07.021
  18. Pinelli F, 2018, J VASC ACCESS, V19, P230, DOI 10.1177/1129729818758999
  19. Raad I, 2014, CLIN INFECT DIS, V59, pS340, DOI 10.1093/cid/ciu670
  20. Reed D, 2020, JCO ONCOL PRACT, V16, pE306, DOI 10.1200/JOP.19.00344
  21. Shim J, 2014, KOREAN J RADIOL, V15, P494
  22. Torres D, 2016, AM J INFECT CONTROL, V44, P432, DOI 10.1016/j.ajic.2015.11.007
  23. Touré A, 2012, AM J INFECT CONTROL, V40, P935, DOI 10.1016/j.ajic.2012.01.024
  24. Vermeulin T, 2018, B CANCER, V105, P1003, DOI 10.1016/j.bulcan.2018.09.005
  25. Taveira MRV, 2017, PEDIATR BLOOD CANCER, V64, P336, DOI 10.1002/pbc.26225
  26. Wang TY, 2015, J FORMOS MED ASSOC, V114, P1055, DOI 10.1016/j.jfma.2015.06.013
  27. Wang YC, 2017, SUPPORT CARE CANCER, V25, P2049, DOI 10.1007/s00520-017-3592-0
  28. Yoshida J, 2011, AM J INFECT CONTROL, V39, pE39, DOI 10.1016/j.ajic.2010.11.013
  29. Zakhour Ramia, 2016, Lancet Infect Dis, V16, pe241, DOI 10.1016/S1473-3099(16)30213-4