The risk of infection associated with intra-arterial catheters for cancer chemotherapy.
OBJECTIVE
To determine the frequency of, and risk factors for, infections associated with intra-arterial catheters used for cancer chemotherapy.


METHODS
Between September 1992 and September 1995, we conducted a surveillance study of all 807 intra-arterial catheters placed for chemotherapy at our center. The insertion site was disinfected with povidone iodine and alcohol, and the arterial catheter was placed using maximal sterile barrier precautions. Upon removal, all intravascular segments were submitted for semi-quantitative culture.


RESULTS
No episodes of catheter-related bloodstream infection (95% confidence interval [CI95], 0%-1.6%) were observed. However, the risk of colonization (>15 colony-forming units) of arterial catheters was 15% (CI95, 12%-17%). Retrospective risk-factor analysis conducted on 224 intra-arterial catheters placed for chemotherapy in 1993 showed that colonization was associated significantly with duration of catheterization (median of 1 day for culture-negative catheters vs median of 4 days for culture-positive catheters, P<.001). Age, gender, prior radiotherapy, underlying cancer, neutropenia, and hypoalbuminemia were not associated with catheter colonization.


CONCLUSIONS
Intra-arterial catheters for cancer chemotherapy placed under maximal sterile barrier precautions for a short period of time are associated with a very low risk of bloodstream infection.
Department of Medical Specialties, University of Texas MD Anderson Cancer Center, Houston 77030, USA.
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I
Raad
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Abi-Said
C H
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Carrasco
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J
Umphrey
L A
LA
Hill
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D002173:Cancer Care Facilities; D002408:Catheters, Indwelling / Q000009:adverse effects*; D015169:Colony Count, Microbial; D003428:Cross Infection / Q000209:etiology*; D004866:Equipment Contamination; D005260:Female; D006801:Humans; D015994:Incidence; D017053:Infection Control / Q000379:methods; D007261:Infusions, Intra-Arterial / Q000295:instrumentation*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012189:Retrospective Studies; D012307:Risk Factors; D013781:Texas; D013997:Time Factors
D000970:Antineoplastic Agents