Please use this identifier to cite or link to this item: https://observatorio.fm.usp.br/handle/OPI/1903
Title: Infection Related to Implantable Central Venous Access Devices in Cancer Patients: Epidemiology and Risk Factors
Authors: FREIRE, Maristela P.PIERROTTI, Ligia C.ZERATI, Antonio E.ARAUJO, Pedro H. X. N.MOTTA-LEAL-FILHO, J. M.DUARTE, Laiane P. G.IBRAHIM, Karim Y.SOUZA, Antonia A. L.DIZ, Maria P. E.PEREIRA, JulianaHOFF, Paulo M.ABDALA, Edson
Citation: INFECTION CONTROL AND HOSPITAL EPIDEMIOLOGY, v.34, n.7, p.671-677, 2013
Abstract: OBJECTIVE. To describe the epidemiology of infections related to the use of implantable central venous access devices (CVADs) in cancer patients and to evaluate measures aimed at reducing the rates of such infections. DESIGN. Prospective cohort study. SETTING. Referral hospital for cancer in Sao Paulo, Brazil. PATIENTS. We prospectively evaluated all implantable CVADs employed between January 2009 and December 2011. Inpatients and outpatients were followed until catheter removal, transfer to another facility, or death. METHODS. Outcome measures were bloodstream infection and pocket infection. We also evaluated the effects that the creation of a multidisciplinary team for CVAD care, avoiding in-hospital implantation of CVADs, and limiting CVAD insertion in neutropenic patients have on the rates of such infections. RESULTS. During the study period, 966 CVADs (mostly venous ports) were implanted in 933 patients, for a combined total of 243,792 catheter-days. We identified 184 episodes of infection: 154 (84%) were bloodstream infections, 21 (11%) were pocket infections, and 9 (5%) were surgical site infections. During the study period, the rate of CVAD-related infection dropped from 2.2 to 0.24 per 1,000 catheter-days (P < .001). Multivariate analysis revealed that relevant risk factors for such infection include surgical reintervention, implantation in a neutropenic patient, in-hospital implantation, use of a cuffed catheter, and nonchemotherapy indication for catheter use. CONCLUSIONS. Establishing a multidisciplinary team specifically focused on CVAD care, together with systematic reporting of infections, appears to reduce the rates of infection related to the use of these devices.
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Artigos e Materiais de Revistas Científicas - FM/MDR
Departamento de Radiologia - FM/MDR

Artigos e Materiais de Revistas Científicas - HC/ICESP
Instituto do Câncer do Estado de São Paulo - HC/ICESP

Artigos e Materiais de Revistas Científicas - HC/ICHC
Instituto Central - HC/ICHC

Artigos e Materiais de Revistas Científicas - HC/InRad
Instituto de Radiologia - HC/InRad

Artigos e Materiais de Revistas Científicas - LIM/02
LIM/02 - Laboratório de Anatomia Médico-Cirúrgica

Artigos e Materiais de Revistas Científicas - LIM/24
LIM/24 - Laboratório de Oncologia Experimental

Artigos e Materiais de Revistas Científicas - LIM/31
LIM/31 - Laboratório de Genética e Hematologia Molecular

Artigos e Materiais de Revistas Científicas - LIM/37
LIM/37 - Laboratório de Transplante e Cirurgia de Fígado

Artigos e Materiais de Revistas Científicas - LIM/47
LIM/47 - Laboratório de Hepatologia por Vírus

Artigos e Materiais de Revistas Científicas - LIM/54
LIM/54 - Laboratório de Bacteriologia

Artigos e Materiais de Revistas Científicas - LIM/61
LIM/61 - Laboratório de Pesquisa em Cirurgia Torácica

Artigos e Materiais de Revistas Científicas - ODS/03
ODS/03 - Saúde e bem-estar


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