Severe neutropenia at time of port insertion is not a risk factor for catheter‐associated infections in children with acute lymphoblastic leukemia

BACKGROUND: The objective of this study was to determine whether severe neutropenia on the day of port‐a‐catheter (PORT) insertion was a risk factor for catheter‐associated infection (CAI) in children with acute lymphoblastic leukemia (ALL). METHODS: This was a retrospective study of children with ALL who had a PORT insertion between January 2005 and August 2008. Early (≤30 days) and late (>30 days) postprocedure complications were reviewed. The length of follow‐up ranged between 7 months and 42 months. RESULTS: In total, 192 PORTs were inserted in 179 children. There were 43 CAIs (22%), and the infection rate was 0.35 per 1000 catheter‐days. The CAI rate (15%) in children who had severe neutropenia on the day of the procedure did not differ statistically from the CAI rate (24%) in children who did not have severe neutropenia ( P = .137). Conversely, patients with severe neutropenia who had a CAI were more likely to have their PORT removed ( P = .019). The most common organisms to cause catheter removal were coagulase‐negative Staphylococcus and Staphylococcus aureus . Patients with high‐risk ALL had a statistically significant higher incidence of late CAI than patients with standard‐risk ALL ( P = .012). Age ( P = .272), positive blood culture preprocedure ( P = 1.0), and dexamethasone use ( P = .201) were not risk factors for CAI. Patients who had an early CAI did not have a greater chance of having a late CAI. The catheter infection‐free survival rate at 1 year was 88.6%. CONCLUSIONS: The current results indicated that severe neutropenia on the day of PORT insertion does not increase the risk of CAI in children with ALL. Cancer 2010. © 2010 American Cancer Society.