Central venous catheter-related infections after bone marrow transplantation in patients with malignancies: a prospective study with short-course vancomycin prophylaxis.
Infections associated with double-lumen central venous catheters (CVCs) in patients undergoing BMT are presented. We prospectively studied infections occurring with 46 CVCs in 40 patients with malignancies during and up to 30 days after BMT. We randomised patients with insertions of CVCs to receive either a short course of vancomycin 500 mg x 3 peri-operatively (16 CVCs) or no VCM (11 CVCs). Six per cent of CVCs in the group with vancomycin prophylaxis became infected with Gram positive microorganisms compared with 55% in the control group (P < 0.05). Next, 19 patients with CVCs were all given prophylaxis, so finally 35 patients were given vancomycin compared with 11 patients with no vancomycin. In a total of 11 CVC-related infections, 79% of the microbiological isolates were staphylococci, all of which were sensitive to vancomycin. Vancomycin prophylaxis reduced the number of infected CVCs to 11% compared with 45% (P < 0.05) and bacteraemias to 6% compared with 45% (P < 0.01). All infections responded to antibiotic treatment. Prophylactic short-duration vancomycin during insertion of CVCs may reduce the incidence of line-associated infections and Gram positive bacteraemias in patients undergoing BMT.
Vassilomanolakis
M
M
Bone Marrow Transplantation Unit, St. Savas Hospital, Athens, Greece.
Plataniotis
G
G
Koumakis
G
G
Hajichristou
H
H
Skouteri
H
H
Dova
H
H
Efremidis
A P
AP
D016470:Bacteremia / Q000209:etiology / Q000517:prevention & control*; D016026:Bone Marrow Transplantation; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D016908:Gram-Positive Bacterial Infections / Q000209:etiology / Q000517:prevention & control*; D006801:Humans; D009369:Neoplasms / Q000382:microbiology / Q000628:therapy*; D011446:Prospective Studies; D014640:Vancomycin / Q000627:therapeutic use*
D014640:Vancomycin