title: A case-control study to identify risk factors for totally implantable central venous port-related bloodstream infection.
abstract: OBJECTIVE
  To date, the risk factors for central venous port-related bloodstream infection (CVPBSI) in solid cancer patients have not been fully elucidated. We conducted this study in order to determine the risk factors for CVP-BSI in patients with solid cancer.
  
  
  METHODS
  A total of 1,642 patients with solid cancer received an implantable central venous port for delivery of chemotherapy between October 2008 and December 2011 in a single center. CVP-BSI was diagnosed in 66 patients (4%). We selected a control group of 130 patients, who were individually matched with respect to age, sex, and catheter insertion time.
  
  
  RESULTS
  CVP-BSI occurred most frequently between September and November (37.9%). The most common pathogen was gram-positive cocci (n=35, 53.0%), followed by fungus (n=14, 21.2%). Multivariate analysis identified monthly catheter-stay as a risk factor for CVP-BSI (p=0.000), however, its risk was lower in primary gastrointestinal cancer than in other cancer (p=0.002). Initial metastatic disease and long catheter-stay were statistically significant factors affecting catheter life span (p=0.005 and p=0.000). Results of multivariate analysis showed that recent transfusion was a risk factor for mortality in patients with CVP-BSI (p=0.047).
  
  
  CONCLUSIONS
  In analysis of the results with respect to risk factors, prolonged catheter-stay should be avoided as much as possible. It is necessary to be cautious of CVP-BSI in metastatic solid cancer, especially non-gastrointestinal cancer. In addition, avoidance of unnecessary transfusion is essential in order to reduce the mortality of CVP-BSI. Finally, considering the fact that confounding factors may have affected the results, conduct of a well-designed prospective controlled study is warranted.
authors.affiliation: Division of Medical Oncology, Department of Internal Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea.
authors.forename: Guk Jin
authors.initials: GJ
authors.lastname: Lee
authors.forename: Sook Hee
authors.initials: SH
authors.lastname: Hong
authors.forename: Sang Young
authors.initials: SY
authors.lastname: Roh
authors.forename: Sa Rah
authors.initials: SR
authors.lastname: Park
authors.forename: Myung Ah
authors.initials: MA
authors.lastname: Lee
authors.forename: Hoo Geun
authors.initials: HG
authors.lastname: Chun
authors.forename: Young Seon
authors.initials: YS
authors.lastname: Hong
authors.forename: Jin Hyoung
authors.initials: JH
authors.lastname: Kang
authors.forename: Sang Il
authors.initials: SI
authors.lastname: Kim
authors.forename: Youn Jeong
authors.initials: YJ
authors.lastname: Kim
authors.forename: Ho Jong
authors.initials: HJ
authors.lastname: Chun
authors.forename: Jung Suk
authors.initials: JS
authors.lastname: Oh