Serious complications of vascular catheter-related Staphylococcus aureus bacteremia in cancer patients.
Over the period 1986 to 1989, 53 cancer patients were identified with catheter-related Staphylococcus aureus bacteremia at the University of Texas M.D. Anderson Cancer Center. Septic thrombosis was diagnosed in 12 (23%) patients and was suspected in another 3 (6%). Of the 12 patients, five developed deep-seated infections (septic emboli, endocarditis, meningitis, abscess), compared with 2 of the 38 other patients with no septic thrombosis (p < 0.01). Fever persisted for more than three days after antibiotic initiation in 52% of the patients with complications (septic thrombosis and/or deep-seated infections), compared with 19% of those without complications (p < 0.02). Of the three patients with complications who were treated for 14 days with intravenous antistaphylococcal antibiotics, two relapsed; in contrast, all of the nine patients with complications who were treated for more than 14 days (mean 4 weeks) were cured, and none relapsed (p < 0.05). Of the nine patients with complications who were treated with a long course of therapy, only one required surgery. The possibility of septic thrombosis and/or deep-seated infections should be considered in all cancer patients with catheter-related Staphylococcus aureus bacteremia, and if present, the condition should be treated with appropriate intravenous antibiotics for at least four weeks.
Raad
I
I
Department of Medical Specialties, University of Texas M.D. Anderson Cancer Center, Houston 77030.
Narro
J
J
Khan
A
A
Tarrand
J
J
Vartivarian
S
S
Bodey
G P
GP
D000328:Adult; D000368:Aged; D016470:Bacteremia / Q000150:complications* / Q000382:microbiology; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000628:therapy*; D012189:Retrospective Studies; D013203:Staphylococcal Infections / Q000150:complications* / Q000209:etiology; D013927:Thrombosis / Q000453:epidemiology / Q000209:etiology