Hickman catheter site infections after allogeneic stem cell transplantation: single-center experience.
Hickman catheter site infections are known to increase transplant-related mortality (TRM). A retrospective analysis of 103 patients who received allogeneic SCT (stem cell transplants) was performed to define the incidence and outcomes of Hickman infections. Seventy-six patients received peripheral blood stem cells (PBSCs) (73.8%) and 29 patients (28.2%), nonmyeloablative conditioning. During the median follow-up of 9 months, Hickman infections were observed in 10 patients (9.7%) at a median onset of 32 days posttransplantation (range, 2-102 days). The causative organisms were identified in 5 cases, including Staphylococcus species (n=4) and Pseudomonas aeruginosa (n=1). Six events were successfully resolved with antibiotic treatment, whereas the other 4 events required the removal of the Hickman catheters with subsequent death in 2 cases. The survival duration for the Hickman infection group was shorter than that for the Hickman no infection group (83 days vs 366 days, respectively; P <.001). Myeloid engraftment was delayed in the Hickman infection group (18.0 days vs 15.0 days, respectively; P=.038), plus Hickman infections were more frequent among BMT compared with PBSCT group (22.2% vs 5.3%, respectively, P=.019). Hickman infections were associated with TRM, especially during the first 3 months posttransplantation. As such, the current results emphasize both the importance of Hickman catheter care and the need for surveillance cultures after SCT.
Kim
D H
DH
Department of Hematology/Oncology, Stem Cell Transplantation Center, Kyungpook National University Hospital, Daegu, Korea.
Bae
N Y
NY
Sung
W J
WJ
Kim
J G
JG
Kim
S W
SW
Sohn
S K
SK
Lee
K B
KB
D000293:Adolescent; D000328:Adult; D001424:Bacterial Infections / Q000453:epidemiology; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007951:Leukemia, Myeloid / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000628:therapy; D009190:Myelodysplastic Syndromes / Q000628:therapy; D011552:Pseudomonas Infections / Q000453:epidemiology; D011550:Pseudomonas aeruginosa; D012189:Retrospective Studies; D013203:Staphylococcal Infections / Q000453:epidemiology; D033581:Stem Cell Transplantation / Q000009:adverse effects*; D014184:Transplantation, Homologous