PS1590 CENTRAL VEIN CATHETERIZATION IN ONCOHEMATOLOGICAL PRACTICE: RISK OF COMPLICATIONS

Background: The insertion of the central venous catheter (CVC) is a vascular access method used in resuscitation and oncohematology and it is required during intensive infusion and chemotherapy. However, due to the invasiveness of the procedure, complications are possible due to the procedure and course of the underlying disease. Aims: Assess the frequency of complications related to central vein catheterization in patients with hematology malignancies (HM). Methods: We have analyzed 2506 cases of CVC performed to patients with HM for the period from 2003 to 2018. All patients underwent catheterization of the right (82%), left (17.6%) subclavian vein or v. Jugularis externa (0.4%). Bacteriology tests were performed if a catheter‐related infection was suspected (n = 353). Results: Out of 2506 catheterizations bloodstream infections in the form of sepsis or bacteremia were documented in 2.5% of patients (n = 63), phlebitis, thrombophlebitis and infiltrate at CVC area were revealed in 2.6% (n = 66), lymphorrhea – in 1.3% (n = 33), catheter bleeding – in 3.9% (n = 73), haematoma – in 4.3% (n = 109), artery puncture (a. Subclavia dextra or sinistra) – in 3.0% (n = 76), pain, numbness, paresthesia of the upper limb – in 1.6% (n = 41), weakness, collapse – in 1.1% (n = 27), pneumothorax – in 0.2% of patients(n = 4). Positive bacterial cultures from venous blood were detected in 63 patients, with mixed infection in 8 cases (2 or 3 microorganisms). Detailed analysis of the infectious pathogens have demonstrated the prevalence of coagulase‐negative staphylococcus (Staph. epidermidis) – 56.3% (n = 40), At the same time, a relatively large percentage was represented by Staphylococcus aureus – 5.7% (n = 4), Micrococcus spp. – 1.4% (n = 1), Enterococcus spp. – 1.4% (n = 1). Gram‐negative microorganisms were detected in 26.7% (n = 19) of cases: Escherichia coli – 14.1% (n = 10) patients, Enterobacter spp. – 5.6% (n = 4), Enterobacter aerogenes – 1.4% (n = 1), Acinetobacter spp. – 1.4% (n = 1), Pseudomonas aeruginosa – 1.4% (n = 1), Neisseria spp. – 2.8% (n = 2). Causative agents of fungal infections were found for 8.5% of patients (n = 6), including fungi of the genus Candida – 7.1% (C. albicans (n = 4), C. crusei (n = 1), Rhodotorula spp. – 1.4% (n = 1). Summary/Conclusion: In patients with HM among catheter‐associated infections, coagulase‐negative staphylococcal infection (Staph. epidermidis) is most prevalent, which is most likely due to contact route of infection.