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Central venous catheter and Stenotrophomonas maltophilia bacteremia in cancer patients
Author(s) -
Boktour Maha,
Hanna Hend,
Ansari Shoaib,
Bahna Boulos,
Hachem Ray,
Tarrand Jeffrey,
Rolston Kenneth,
Safdar Amar,
Raad Issam
Publication year - 2006
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.21846
Subject(s) - bacteremia , stenotrophomonas maltophilia , medicine , catheter , central venous catheter , odds ratio , confidence interval , surgery , intensive care unit , cancer , antibiotics , pseudomonas aeruginosa , microbiology and biotechnology , bacteria , genetics , biology
Abstract BACKGROUND Stenotrophomonas maltophilia bacteremia is frequently found in cancer patients. This study attempted to determine how often the catheters were the source of this infection and the risk factors associated with catheter‐related bacteremias. METHODS The microbiology records were retrospectively reviewed of all cancer patients having S. maltophilia bacteremia and indwelling central venous catheters seen between January 1998 and January 2004. In a multivariate analysis the patients' clinical characteristics, antimicrobial therapy, outcome, and source of bacteremia that were significantly associated with definite catheter‐related S. maltophilia bacteremia as opposed to secondary bacteremia were identified. RESULTS A total of 217 bacteremias were identified in 207 patients: 159 (73%) were primary catheter‐related (53 definite, 89 probable, and 17 possible), 11 (5%) were primary noncatheter‐related, and 47 (22%) were secondary. Multivariate analysis showed the following factors to be independently associated with definite catheter‐related bacteremias: 1) polymicrobial bacteremia (odds ratio [OR], 7.6; 95% confidence interval [95% CI], 1.3–45.5); 2) no prior intensive care unit admission (OR, 0.06; 95% CI, 0.005–0.578); and 3) nonneutropenic status at onset (OR, 0.07; 95% CI, 0.013–0.419). The response rate to appropriate antibiotics and catheter removal was 95% in the patients with definite catheter‐related bloodstream infections, compared with only 56% in the patients with secondary bacteremias ( P = .001). CONCLUSIONS The majority of the S. maltophilia bacteremias occurring in cancer patients with indwelling central venous catheters appear to be catheter‐related and are often polymicrobial. Catheter‐related S. maltophilia bacteremias occurred more frequently in noncritically ill, nonneutropenic patients, and prompt removal of the catheter was found to be associated with a better prognosis. Cancer 2006. © 2006 American Cancer Society.