Risk of bacteremia in patients with hematological and other malignancies after initial placement of a central venous catheter.
BACKGROUND
Widespread use of central venous access devices has made catheter-related bacteremia an important concern. Therefore, we conducted a follow-up study on the risk of bacteremia in Danish patients with hematological or other malignancies after placement of their first central venous access devise.


METHODS
At a Danish university hospital we identified 357 patients with hematological or other malignancies during a three-year period, 2000-2002. Data on catheter placement and bacteremias were obtained from hospital registries. Clinical data were abstracted from patients' charts.


RESULTS
104 patients had a hematological malignancy (hem) and 253 patients had other malignancies (solid tumor). A total of 55 patients (34/21) developed bacteremia following catheter placement. After adjustment for age, sex, and comorbidity, the relative risk of bacteremia in the hem compared with the solid tumor group was 10.8 (95%; CI, 5.8-20.1). In both groups, the central venous catheter was the most frequent focus of infection with no major difference in proportion (50% and 33%, respectively); an unknown focus was also common (50% and 19%, respectively).


CONCLUSIONS
Patients with hematological malignancies had a 10-fold increased risk of bacteremia compared with other cancer patients and the central venous catheter was not the only important focus.
Pedersen
Gitte
G
Department of infectious Diseases, Aalborg Hospital, Denmark. gitte.pedersen@dadlnet.dk
Nørgaard
Mette
M
Kiiveri
Mathilda
M
Schønheyder
Henrik Carl
HC
Larsson
Heidi
H
Stolberg
Erik
E
Andersen
Petra Witt
PW
Sørensen
Henrik Toft
HT
D000328:Adult; D016470:Bacteremia / Q000453:epidemiology* / Q000209:etiology; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D016001:Confidence Intervals; D005260:Female; D005500:Follow-Up Studies; D019337:Hematologic Neoplasms / Q000628:therapy*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors