title: Incidence and risk factors for central venous access port-related infection in Chinese cancer patients.
abstract: OBJECTIVE
  Cytotoxic chemotherapy via central venous access ports is an important part of the standard treatment for most cancers, but it is accompanied with the risk of infections. This study aimed to analyze the incidence and risk factors for central venous access port-related infection (CPI) among Chinese patients receiving cytotoxic chemotherapy.
  
  
  METHODS
  Between January 1, 2002 and December 31, 2005 a total of 1391 cancer patients with 1449 totally implantable central venous access ports were evaluated. The log-rank test and Cox proportional hazards model were used for the analyses of risk factors.
  
  
  RESULTS
  The overall CPI incidence rate was 0.21 per 1000 catheter-days. Hematological malignancies and head and neck cancer were associated with an increased risk of CPI (hazard ratio 4.00 and 4.11, respectively, both p < 0.001) and less infection-free catheter longevity (p < 0.001) compared with other cancer types. Chemotherapy in an adjuvant setting was associated with a lower risk of infection than for patients in a nonadjuvant setting (p < 0.001). The most common pathogens isolated from CPI were Pseudomonas aeruginosa and Candida.
  
  
  CONCLUSIONS
  Infection remains to be a challenging issue for totally implantable central venous ports. Implementation of an insertion bundle for the prevention of central line-associated bloodstream infections is warranted, especially for those patients with hematological and head and neck cancers, as well as for patients receiving chemotherapy in the metastatic settings.
authors.affiliation: Division of Hematology Oncology, Department of Medicine, Chang Gung Memorial Hospital-Chiayi, Puzi City, Taiwan, ROC.
authors.forename: Ting-Yao
authors.initials: TY
authors.lastname: Wang
authors.affiliation: Division of Hematology Oncology, Department of Medicine, Chang Gung Memorial Hospital-Chiayi, Puzi City, Taiwan, ROC.
authors.forename: Kuan-Der
authors.initials: KD
authors.lastname: Lee
authors.affiliation: Division of Hematology Oncology, Department of Medicine, Chang Gung Memorial Hospital-Chiayi, Puzi City, Taiwan, ROC.
authors.forename: Ping-Tsung
authors.initials: PT
authors.lastname: Chen
authors.affiliation: Division of Hematology Oncology, Department of Medicine, Chang Gung Memorial Hospital-Chiayi, Puzi City, Taiwan, ROC.
authors.forename: Min-Chi
authors.initials: MC
authors.lastname: Chen
authors.affiliation: Division of Hematology Oncology, Department of Medicine, Chang Gung Memorial Hospital-Chiayi, Puzi City, Taiwan, ROC.
authors.forename: Yi-Yang
authors.initials: YY
authors.lastname: Chen
authors.affiliation: Division of Hematology Oncology, Department of Medicine, Chang Gung Memorial Hospital-Chiayi, Puzi City, Taiwan, ROC.
authors.forename: Cih-En
authors.initials: CE
authors.lastname: Huang
authors.affiliation: Division of Hematology Oncology, Department of Medicine, Chang Gung Memorial Hospital-Chiayi, Puzi City, Taiwan, ROC.
authors.forename: Feng-Che
authors.initials: FC
authors.lastname: Kuan
authors.affiliation: Division of Hematology Oncology, Department of Medicine, Chang Gung Memorial Hospital-Chiayi, Puzi City, Taiwan, ROC.
authors.forename: Chih-Cheng
authors.initials: CC
authors.lastname: Chen
authors.affiliation: Division of Hematology Oncology, Department of Medicine, Chang Gung Memorial Hospital-Chiayi, Puzi City, Taiwan, ROC. Electronic address: q12014@adm.cgmh.org.tw.
authors.forename: Chang Hsien
authors.initials: CH
authors.lastname: Lu
mesh_terms: D061605:Administration, Intravenous; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D055499:Catheter-Related Infections / Q000453:epidemiology*; D062905:Central Venous Catheters / Q000009:adverse effects* / Q000382:microbiology; D004358:Drug Therapy / Q000379:methods; D005260:Female; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications* / Q000188:drug therapy; D016016:Proportional Hazards Models; D012307:Risk Factors; D013624:Taiwan; D055815:Young Adult
keywords: cancer care facilities; catheter-related infections; vascular access devices