This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Mukau, L. Articles by Mcguire, M. E. Search for Related Content PubMed PubMed Citation Articles by Mukau, L. Articles by Mcguire, M. E. Social Bookmarking                         What's this?

Long-Term Central Venous Access vs Other Home Therapies: Complications in Patients With Acquired Immunodeficiency Syndrome

The Johns Hopkins University School of Medicine, Department of Surgery, Baltimore, Maryland

Mark A. Talamini, MD

The Johns Hopkins University School of Medicine, Department of Surgery, Baltimore, Maryland

James V. Sitzmann, MD

The Johns Hopkins University School of Medicine, Department of Surgery, Baltimore, Maryland

R. Cartland Burns, MD

The Johns Hopkins University School of Medicine, Department of Surgery, Baltimore, Maryland

Mary E. Mcguire, BSN, RN

The Johns Hopkins University School of Medicine, Department of Surgery, Baltimore, Maryland

One hundred and forty silicone catheters were inserted in 127 patients for long-term intravenous access with a cumulative follow-up time of 21,125 catheter-days (58 patient-years). Fifty-six patients had acquired immunodeficiency syndrome (AIDS); 44 were not AIDS patients and were receiving ambulatory home parenteral nutrition, whereas the remaining 27 did not have AIDS and were receiving home antibiotic therapy. Patients had a mean of 1.1 catheters inserted, and the rate of Hickman catheter-related sepsis was 0.18 per 100 catheter days or 0.6 septic episodes per patient year of treatment. Catheter-related sepsis was higher in AIDS patients (p < .01) and in patients receiving parenteral nutrition (p < .05) compared with those receiving antibiotic therapy. Prior catheter infection and AIDS were the most significant predictors of catheter infection (p < .01). Staphylococcus aureus was the most commonly isolated pathogen (61%) in AIDS patients. Fever (p < .001) and relative leukocytosis (p < .02) were the most common signs of infection. Only 14 infected catheters (37.8%) were salvaged by antibiotic therapy after the initial infection episode, and 6 of these catheters (42.9%) had recurrent multiple infections. In addition, inflammatory bowel disease was found to be a risk factor for venous thrombosis (p = .018). We conclude that because immunocompromised patients have a high risk of infection, catheter-related sepsis in these patients should be treated by catheter removal and antibiotics. (Journal of Parenteral and Enteral Nutrition 16:455-459, 1992)

Journal of Parenteral and Enteral Nutrition, Vol. 16, No. 5, 455-459 (1992)
DOI: 10.1177/0148607192016005455


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				D. G. Maki, D. M. Kluger, and C. J. Crnich The Risk of Bloodstream Infection in Adults With Different Intravascular Devices: A Systematic Review of 200 Published Prospective Studies Mayo Clin. Proc., September 1, 2006; 81(9): 1159 - 1171. [Abstract] [Full Text] [PDF]

				D. R. Duerksen, A. Ahmad, J. Doweiko, B. R. Bistrian, and E. A. Mascioli Risk of Symptomatic Central Venous Thrombotic Complications in AIDS Patients Receiving Home Parenteral Nutrition JPEN J Parenter Enteral Nutr, July 1, 1996; 20(4): 302 - 305. [Abstract] [PDF]

				A.S.P.E.N. Board Guidelines for the Use of Parenteral and Enteral Nutrition in Adult and Pediatric Patients JPEN J Parenter Enteral Nutr, July 1, 1993; 17(4_suppl): 1SA - 52SA. [PDF]