Central venous line infections in AIDS.
The relative infection rates of Port-a-Cath and Hickman lines used for the maintenance treatment of cytomegalovirus retinitis were studied by retrospective casenote review. Seventy-five lines were inserted over an 18 month period. The overall infection rates were significantly greater for Hickman lines: 0.97/100 line-days compared to 0.39/100 line-days for Port-a-Caths, with a trend towards higher infection rates in those prescribed ganciclovir. A total of 56 episodes of septicaemia were recorded with a significantly greater incidence of septicaemia within 1 month of line insertion in those with a neutrophil count < 1.0 x 10(3)/mm3. Ten infectious episodes were associated with death, six of which were due to Pseudomonas spp.


CONCLUSIONS
In HIV seropositive patients, use of a Port-a-Cath is associated with a significantly lower rate of line associated sepsis than use of a Hickman line. Insertion of long term central venous catheters should be avoided if possible when the neutrophil count is < 1.0 x 10(3)/mm3.
Moore
D A
DA
St Stephen's Centre, Chelsea and Westminster Healthcare Trust, London, U.K.
Gazzard
B G
BG
Nelson
M R
MR
D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy*; D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy* / Q000401:mortality; D000328:Adult; D000998:Antiviral Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D002405:Catheterization, Central Venous / Q000009:adverse effects; D002408:Catheters, Indwelling / Q000009:adverse effects / Q000382:microbiology*; D017726:Cytomegalovirus Retinitis / Q000188:drug therapy*; D004866:Equipment Contamination; D005260:Female; D017245:Foscarnet / Q000008:administration & dosage / Q000627:therapeutic use; D015774:Ganciclovir / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D008297:Male; D018805:Sepsis / Q000209:etiology*; D016019:Survival Analysis; D014946:Wound Infection / Q000209:etiology*
D000998:Antiviral Agents; D017245:Foscarnet; D015774:Ganciclovir