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Micrococcus-associated central venous catheter infection in patients with pulmonary arterial hypertension

Ronald J Oudiz1, Allison Widlitz, X Joy Beckmann

  • 1Division of Cardiology, Research & Education Institute, Harbor-UCLA Medical Center, Torrance, CA 90502, USA. oudiz@humc.edu

Chest
|July 14, 2004
PubMed
Abstract

Insights

Catheter-related infections in pulmonary arterial hypertension (PAH) patients receiving epoprostenol (EPO) were infrequent. Micrococcus spp. emerged as a significant pathogen, requiring clinical attention in PAH treatment.

Area of Science:

  • Infectious Diseases
  • Cardiology
  • Medical Microbiology

Background:

  • Pulmonary arterial hypertension (PAH) often requires long-term treatment with intravenous epoprostenol (EPO).
  • Central venous catheters are essential for EPO delivery, posing a risk of catheter-related infections (CRIs).
  • The role of specific microorganisms, such as Micrococcus spp., as pathogens in CRIs is not well-established.

Purpose of the Study:

  • To determine the incidence of CRIs in PAH patients treated with continuous EPO.
  • To investigate the etiological role of Micrococcus spp. in these infections.

Main Methods:

  • Observational study conducted at two specialized PAH treatment centers.
  • 192 PAH patients receiving continuous IV EPO via central venous catheter from 1987 to 2000.
  • Standardized sterile catheter care protocols were followed; infections were verified through patient reports and laboratory data.

Main Results:

  • A total of 335,285 catheter days were analyzed, with a CRI rate of 0.26 per 1,000 catheter days.
  • 88 clinical CRIs occurred, 51 of which were blood culture-positive, leading to catheter removal in 38 cases.
  • Staphylococcus aureus was the most common pathogen (25 cases), followed by Micrococcus spp. (14 cases).

Conclusions:

  • Continuous EPO therapy in PAH patients is associated with a low incidence of CRIs.
  • Micrococcus spp. was identified as the second most frequent causative agent and should be considered a pathogen, not a contaminant.
  • Awareness of CRI risks, including those posed by Micrococcus spp., is crucial for managing PAH patients on EPO therapy to mitigate morbidity and mortality.

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