title: Management of infections related to totally implantable venous-access ports: challenges and perspectives.
abstract: Use of totally implantable venous-access ports (TIVAPs) is standard practice for patients with diseases such as solid-tumour cancers, haematological malignancies, and chronic digestive diseases. Use of TIVAPs allows long-term administration of venotoxic compounds, improves patients' quality of life, and reduces the risk of infection. Microbial contamination, formation of pathogenic biofilms, and infection, however, are associated with morbidity, mortality, and increased health-care costs. Local and systemic complications or infections related to specific pathogens might lead to device removal. Alternatively, conservative treatment with combined systemic antibiotics and antibiotic lock therapy might be useful. We discuss in-vitro and in-vivo basic and clinical research findings on the epidemiology, diagnosis, and prevention of TIVAP-related infections, the current challenges to management, promising strategies, and some treatments in development that are likely to improve outcomes of TIVAP-related infections, with a particular focus on antibiotic lock therapy.
authors: Institut Pasteur, Unité de Génétique des Biofilms, Paris, France.
authors: David
authors: D
authors: Lebeaux
authors: Servei de Malalties Infeccioses, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors: Nuria
authors: N
authors: Fernández-Hidalgo
authors: Institut Pasteur, Unité de Génétique des Biofilms, Paris, France.
authors: Ashwini
authors: A
authors: Chauhan
authors: New Mexico Veterans Healthcare System and University of New Mexico, Albuquerque, NM, USA.
authors: Samuel
authors: S
authors: Lee
authors: Institut Pasteur, Unité de Génétique des Biofilms, Paris, France.
authors: Jean-Marc
authors: JM
authors: Ghigo
authors: Servei de Malalties Infeccioses, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain. Electronic address: benitoalmirante@gmail.com.
authors: Benito
authors: B
authors: Almirante
authors: Institut Pasteur, Unité de Génétique des Biofilms, Paris, France. Electronic address: cbeloin@pasteur.fr.
authors: Christophe
authors: C
authors: Beloin
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016470:Bacteremia / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D058387:Candidemia / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D055499:Catheter-Related Infections / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D002405:Catheterization, Central Venous / Q000295:instrumentation* / Q000379:methods; D002408:Catheters, Indwelling / Q000009:adverse effects*; D020878:Device Removal; D006801:Humans; D012307:Risk Factors
chemical_list: D000900:Anti-Bacterial Agents