title: Presentation and impact of catheter-associated thrombosis in patients with infected long-term central venous catheters: a prospective bicentric observational study.
abstract: BACKGROUND
  Catheter-associated thrombosis (CAT) in patients with infected long-term central venous catheter (LTCVC) has been poorly studied.
  
  
  METHODS
  We prospectively included patients with infected LTCVC and collected clinical data. Doppler ultrasound was systematically performed to screen for CAT. Outcome (death or infection relapse) was evaluated 12 weeks after infection diagnosis.
  
  
  RESULTS
  90 patients were included and CAT was diagnosed in 27 (30%). Local signs suggesting infection were more frequent in patients with CAT than without (11/27 versus 8/63, p = 0.03). Outcome was similar in patients with and without CAT. However, median duration of antimicrobials was longer (18 versus 14 days, p = 0.02), catheter removal tended to be more frequent (24/27 versus 46/63, p = 0.08), and anticoagulant therapy more often prescribed (17/27 versus 6/63, p < 0.01) in patients with CAT than without. Patients with occlusive thrombosis were more likely to have Staphylococcus aureus infections (4/7 versus 1/17, p = 0.02) and prolonged positivity of blood-cultures (3/7 versus 1/15, p = 0.02), than patients with non-occlusive thrombosis.
  
  
  CONCLUSIONS
  CAT is associated with local signs suggesting infection. A more aggressive treatment in CAT cases allowed a similar outcome at 12 weeks between patients with and without CAT. Occlusive thrombosis represented a subgroup of patients at risk of delayed clearance of bacteremia.
authors.affiliation: a Department of Internal Medicine , Assistance Publique-Hôpitaux De Paris, University Hospital Beaujon , Clichy , France ;
authors.forename: Adrien
authors.initials: A
authors.lastname: Galy
authors.affiliation: b Antimicrobial Stewardship Team, Assistance Publique-Hôpitaux De Paris, University Hospital Henri Mondor , Créteil , France.
authors.forename: Raphaël
authors.initials: R
authors.lastname: Lepeule
authors.affiliation: a Department of Internal Medicine , Assistance Publique-Hôpitaux De Paris, University Hospital Beaujon , Clichy , France ;
authors.forename: Tiphaine
authors.initials: T
authors.lastname: Goulenok
authors.affiliation: a Department of Internal Medicine , Assistance Publique-Hôpitaux De Paris, University Hospital Beaujon , Clichy , France ;
authors.forename: Rodolphe
authors.initials: R
authors.lastname: Buzele
authors.affiliation: a Department of Internal Medicine , Assistance Publique-Hôpitaux De Paris, University Hospital Beaujon , Clichy , France ;
authors.forename: Victoire
authors.initials: V
authors.lastname: de Lastours
authors.affiliation: a Department of Internal Medicine , Assistance Publique-Hôpitaux De Paris, University Hospital Beaujon , Clichy , France ;
authors.forename: Bruno
authors.initials: B
authors.lastname: Fantin
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000925:Anticoagulants / Q000627:therapeutic use; D016470:Bacteremia / Q000188:drug therapy / Q000209:etiology / Q000382:microbiology; D055499:Catheter-Related Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D062905:Central Venous Catheters / Q000382:microbiology*; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000209:etiology; D013211:Staphylococcus aureus / Q000302:isolation & purification; D013927:Thrombosis / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy; D016896:Treatment Outcome; D018608:Ultrasonography, Doppler
chemical_list: D000900:Anti-Bacterial Agents; D000925:Anticoagulants
keywords: Catheter associated thrombosis; catheter infection; long-term central venous catheter