Results of antibiotic treatment of Hickman-catheter-related infections in oncological patients.
A group of 330 oncological patients were supported throughout a 7-year period with central venous catheters (Broviac/Hickman catheters) and underwent standard oncological chemotherapy, because of hematological malignancies or solid tumors (156 children), or a myeloablative conditioning regimen followed by bone marrow transplantation because of leukemia or lymphoma (174 patients: 110 adults, 64 children). Of these, 17 patients (8 after bone marrow transplantation) developed a catheter-related bacteremia and were treated by at least two antibiotics according to the sensitivity of the bacteria. In 1 patient the catheter (infected by Bacillus cereus) was removed on day 25 of antibiotic treatment because of persistent high fever and further positive blood cultures. After bone marrow transplantation, 2 other patients, with a Pseudomonas or a Staphylococcus infection respectively, did not respond to the combined antibiotic treatment and died 1 week and 7 weeks later, respectively, from transplant-related severe graft-versus-host disease. In the other 14 patients antibiotic treatment was successful and removal of the central-vein catheter could be avoided.
Simon
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C
Abteilung Allgemeine Pädiatrie, Universitäts-Kinderklinik, Kiel, Germany.
Suttorp
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D000328:Adult; D000900:Anti-Bacterial Agents; D016470:Bacteremia / Q000097:blood / Q000188:drug therapy* / Q000209:etiology* / Q000382:microbiology / Q000401:mortality; D002405:Catheterization, Central Venous / Q000009:adverse effects* / Q000295:instrumentation; D002408:Catheters, Indwelling / Q000009:adverse effects*; D002648:Child; D002985:Clinical Protocols; D004359:Drug Therapy, Combination / Q000627:therapeutic use*; D004866:Equipment Contamination; D006801:Humans; D008826:Microbial Sensitivity Tests; D009369:Neoplasms / Q000188:drug therapy*; D012307:Risk Factors; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents