title: Nontunneled central venous catheters in patients with AIDS are associated with a low infection rate.
abstract: Patients with AIDS frequently require long-term central venous access devices for intravenous (IV) therapy. We reviewed the medical records of all HIV-infected patients at a single large urban hospital who had a central venous catheter (CVC) placed during a 1-year period to assess the overall complication rate, infection rate, and the microbiology of infectious complications. One hundred fifty-six catheters were inserted in 87 patients for 11,041 catheter days. These catheters (142 of 156) were primarily nontunneled, nonimplantable CVCs (NT-CVCs), and analyses were limited to these. Of these catheters, 79% were primarily used to treat disease caused by cytomegalovirus (CMV). The complication rate for the NT-CVCs was 5.1/1000 catheter days with a mean time to any complication of 106 days. The total infection rate of the NT-CVCs was 2.8/1000 catheter days, and the serious infection rate (bacteremia) for the NT-CVCs was 1.4/1000 catheter days. The mean time to a serious infection was 407 days. None of the following parameters was associated with an increased infection rate: HIV risk factor, indication for catheter, medications received via catheter, number of catheter ports, anatomic site of catheter insertion, or the presence of neutropenia. NT-CVCs were associated with low complication and infection rates that were comparable with historical rates seen in AIDS patients with tunneled and totally implantable central venous access devices. NT-CVCs may be a safe, cost-effective alternative to other central venous access devices in patients with HIV/AIDS.
authors.affiliation: The University of Texas Southwestern Medical Center, Dallas 75235-9133, USA.
authors.forename: D J
authors.initials: DJ
authors.lastname: Skiest
authors.forename: P
authors.initials: P
authors.lastname: Grant
authors.forename: P
authors.initials: P
authors.lastname: Keiser
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology; D000328:Adult; D000998:Antiviral Agents / Q000008:administration & dosage; D016470:Bacteremia / Q000453:epidemiology / Q000209:etiology*; D002405:Catheterization, Central Venous / Q000009:adverse effects / Q000379:methods*; D005260:Female; D015774:Ganciclovir / Q000008:administration & dosage; D006801:Humans; D007239:Infections / Q000453:epidemiology / Q000209:etiology*; D008297:Male; D009017:Morbidity; D011030:Pneumothorax / Q000453:epidemiology / Q000209:etiology; D012307:Risk Factors
chemical_list: D000998:Antiviral Agents; D015774:Ganciclovir