IDWeek 2019 — Catheter removal improves survival in cancer patients


  • Devona Williams, Pharm.D.
  • Conference Reports
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Takeaway

  • Catheter removal within 48 hours of gram-negative bacteremia improves mortality outcomes in patients with cancer who have central-line infections.

Why this matters

  • Cancer patients with gram-negative bloodstream infections are at risk for morbidity and mortality.
  • Understanding optimal management of central venous catheters (CVCs) in the setting of gram-negative bacteremia will improve survival outcomes.

Study design

  • Retrospective review of microbiology data for cancer patients age 14 and older reported as having a central venous catheter and gram-negative bloodstream infection.
  • Patients were divided into 3 categories:
    • CVC infection without mucosal injury (Group 1);
    • CVC infection with mucosal injury (Group 2);
    • Infection source other than CVC (Group 3).

Key results

  • The most common organism in patients with CVC and no mucosal injury was Pseudomonas aeruginosa (20%).
  • The most common organism in patients with mucosal injury or non-CVC infections was Escherichia coli (66% and 44%).
  • Group 1 intervention was the only population with a significant difference in outcomes based on timing of CVC removal.
  • There was a decrease in mortality rate at 3 months in group 1 patients who had CVC removal within 48 hours, 3% vs 19%, OR=0.13 (95% CI, 0.03-0.68), P=.016.

Limitations

  • Single-center report.
  • Results presented at conference and not peer-reviewed.

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