Subcutaneously implanted central venous access device infection in pediatric patients with cancer

Subcutaneously implanted central venous access devices (SICVADs) are a common route of intravascular access for pediatric patients with cancer. This study was performed to evaluate the risk for SICVAD-related infection in a large consecutive series of unselected children with cancer in a single medical center.

The medical charts of 209 pediatric patients with cancer who received a SICVAD from January 1, 2001 to December 31, 2005 were retrospectively reviewed, and the patients were followed-up until June 30, 2006. The demographics, clinicopathologic features, and infectious complications were collected for analysis.

There were 137,924 SICVAD days (median, 660 days; range, 16-1962 days). The rate of SICVAD-related infections was 0.15 episodes/1000 SICVAD days. There were 21 episodes of SICVAD-related infection among 17 patients, 18 were bloodstream infection among 14 patients and the other 3 were local infection among 3 patients. Sixteen SICVADs were removed, 13 were associated with bloodstream infection and 3 with local infection. Young age (<2 years) was associated with a high risk for SICVAD-related infection. Staphylococcal spp. and fungi were the most common pathogens associated with SICVADs.

The rate of SICVAD-related infection in children with cancer was low. Children younger than 2 years had a higher risk for SICVAD-related infection than older children. Fungi play an important role in SICVAD-related infection.