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Subcutaneous Infection of Methicillin Resistant Staphylococcus Aureus (MRSA)
Published on: February 10, 2011
Port-A-Cath infections in children with cancer
H Hengartner1, C Berger, D Nadal
1Division of Oncology, University Children's Hospital of Zurich, Steinwiesstrasse 75, Zurich 8032, Switzerland.
Insights
Central venous ports, like Port-A-Cath (PAC), are vital for pediatric cancer patients. This study found a low rate of PAC-related infections, supporting their continued use despite some treatment-resistant cases.
Area of Science:
- Pediatric Oncology
- Infectious Diseases
- Medical Devices
Background:
- Central venous ports, such as Port-A-Cath (PAC), are essential for administering chemotherapy and blood products in pediatric cancer patients.
- PACs are frequently utilized, necessitating an understanding of their associated infection risks.
Purpose of the Study:
- To determine the incidence of PAC-related infections in a large cohort of pediatric cancer patients.
- To assess the impact of these infections on PAC management and patient outcomes.
Main Methods:
- A retrospective analysis of 155 consecutive pediatric cancer patients with PACs.
- Data collection included PAC usage duration and infection events over 134,773 days.
- Infections were categorized as bloodstream or local, with identification of causative organisms.
Main Results:
- The overall rate of PAC-related infections was 0.11 episodes per 1000 PAC days, among the lowest reported.
- 48 bloodstream infections occurred in 26 patients; 12 infections and 3 local infections necessitated PAC removal.
- Coagulase-negative staphylococci were the most common pathogens in treatment-resistant infections.
Conclusions:
- Despite a small percentage requiring removal due to resistant infections, PACs demonstrate a low infection rate in pediatric cancer patients.
- The benefits and extended use of PACs outweigh the risks, supporting their continued application in this population.
Abstract:
Implanted subcutaneous (s.c.) central venous port accesses including Port-A-Cath (PAC) facilitate the administration of chemotherapy or blood products and are frequently used in children with cancer. The incidence of PAC-related infections was determined in 155 consecutive paediatric cancer patients with PAC followed for a total of 134,773 days (median, 738; range, 25-2080). Overall, 48 bloodstream infections occurred in 26 patients. 12 (25%) of these infections and 3 local infections at the insertion site were treatment-resistant and demanded removal of the PAC. Coagulase-negative staphylococci were involved in 12 of these 15 episodes. The rate of clearly PAC-related infections in this so far largest reported series was 0.11 episodes per 1000 PAC days, one of the lowest in the literature. Although catheter-related infections demanded PAC removal in 8% of our patients, the long periods PAC were in use and their benefits argue for continued PAC use in the paediatric cancer population.
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