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

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Tipo de produção
article
Data de publicação
2023
DOI
Scopus
Web of Science
PubMed
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ISSN da Revista
Título do Volume
Editora
CAMBRIDGE UNIV PRESS
Autores
CARLESSE, Fabianne
BELIZARIO, Juliana De Cassia
GERMANO, Priscila Costa Pimentel
VIROLLI, Juliana Monteiro
TURDO, Anna Claudia
RODRIGUES, Beatriz Quental
MACIEL, Amanda Luiz Pires
GONCALVES, Priscila
Citação
INFECTION CONTROL AND HOSPITAL EPIDEMIOLOGY, v.44, n.10, p.1555-1561, 2023
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
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.
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URI
https://observatorio.fm.usp.br/handle/OPI/57439
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Coleções
Artigos e Materiais de Revistas Científicas - FM/MIP
Artigos e Materiais de Revistas Científicas - HC/ICESP
Artigos e Materiais de Revistas Científicas - HC/ICHC
Artigos e Materiais de Revistas Científicas - HC/IPq
Artigos e Materiais de Revistas Científicas - LIM/37
Artigos e Materiais de Revistas Científicas - LIM/47
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