Staphylococcus aureus bacteremia in patients with Hickman catheters.
OBJECTIVE
Determination of outcome and prognostic variables associated with Staphylococcus aureus bacteremia in patients with Hickman catheters.


METHODS
At the University of Washington Medical Center, 37 patients with Hickman catheters and S. aureus bacteremia were studied by retrospective chart review. Clinical features associated with each episode of infection were determined, and the relationships among clinical features, therapy, and outcomes were explored.


RESULTS
Only 18% of all Hickman catheter-associated S. aureus bacteremias and only 10% of those cases with exit site infections were cured without catheter removal. In seven of 41 episodes (17%), death or bacteremic relapse occurred. The best prognosis was found in infections with a low blood culture colony count (less than 1 colony/mL).


CONCLUSIONS
Hickman catheter-associated bacteremia due to S. aureus has a worse prognosis than other Hickman catheter-associated bacteremias. Early catheter removal should be considered except in cases with a remote, noncatheter focus of infection or in infections with no catheter-related physical signs and blood culture colony counts of less than 1/mL.
Dugdale
D C
DC
Department of Medicine, University of Washington School of Medicine, Seattle 98195.
Ramsey
P G
PG
D000328:Adult; D000368:Aged; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D002408:Catheters, Indwelling / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D018805:Sepsis / Q000209:etiology* / Q000628:therapy; D013203:Staphylococcal Infections / Q000209:etiology* / Q000628:therapy