Frequency of broviac catheter infections in pediatric oncology patients

Indwelling, right atrial catheters are important in the care of children with cancer, despite the risk of infection. We have reviewed the records of 64 pediatric oncology patients with 70 Broviac catheters. Fifty infections (17 exit site, 25 septic, and 8 combined) occurred during 17,581 catheter-days, a crude rate of 2.8 infections/1,000 catheter-days. The risk of infection correlated most strongly with age; for example, only children aged one through four years had multiple infections. Overall, 70% of infections were cured without removing the catheter, including 83% of septic infections. However, as compared with newly inserted catheters, the subsequent mean infection-free interval was greatly reduced for catheters associated with a previous, cured infection. Thus, although most Broviac catheter infections can be cured without catheter removal, insertion of a new catheter may nonetheless be necessary in patients who may need prolonged intravenous therapy.