Cure of implantable venous port-associated bloodstream infections in pediatric hematology-oncology patients without catheter removal.
The efficacy of antibiotic treatment of port-associated bloodstream infection without device removal has not been systematically studied. We analyzed the outcome of 43 consecutive port-associated bloodstream infections in pediatric hematology-oncology patients. Etiologies included Staphylococcus epidermidis (30) and Staphylococcus aureus (6). Antibiotics were given through the port for a median of 11 days. Four ports were removed within 72 hours. In 36 (92%) of the remaining 39 episodes, there was a response to antibiotic therapy (defervescence and negative blood culture). In 78% of episodes in which there was a response (excluding two in which the catheters were removed because of mechanical problems), the infections were cured without port removal. Two of the four relapses were cured with a second course of antibiotics. The cure rate was 92% for S. epidermidis infections and 67% for S. aureus infections. Thus, the majority of port-associated bloodstream infections in pediatric hematology-oncology patients can be cured without device removal.
Rubin
L G
LG
Department of Pediatrics, Schneider Children's Hospital of Long Island Jewish Medical Center, New Hyde Park, New York 11040, USA. lrubin@lij.edu
Shih
S
S
Shende
A
A
Karayalcin
G
G
Lanzkowsky
P
P
D016470:Bacteremia / Q000188:drug therapy* / Q000382:microbiology; D002177:Candidiasis / Q000188:drug therapy; D002408:Catheters, Indwelling / Q000009:adverse effects*; D002675:Child, Preschool; D004926:Escherichia coli; D004927:Escherichia coli Infections / Q000188:drug therapy / Q000209:etiology; D016469:Fungemia / Q000188:drug therapy* / Q000382:microbiology; D006402:Hematologic Diseases / Q000150:complications; D006801:Humans; D007710:Klebsiella Infections / Q000188:drug therapy / Q000209:etiology; D007711:Klebsiella pneumoniae; D009369:Neoplasms / Q000150:complications; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000209:etiology; D013211:Staphylococcus aureus; D013212:Staphylococcus epidermidis; D013290:Streptococcal Infections / Q000188:drug therapy / Q000209:etiology; D013298:Streptococcus sanguis; D016896:Treatment Outcome