Infective complications of prolonged central venous (Hickman) catheterization

We reviewed infectious complications during 7,671 days of central venous (Hickman) catheter use in 47 patients receiving intensive cytotoxic and supportive therapy for malignant disease. Colonization of the catheter was identified in eight cases of septicemia, two associated with endocarditis. Septicemia was successfully treated in four of five patients after removal of the catheter and in two of three in whom the catheter remained in situ. Infection of the exit site occurred in five patients but in only one was there associated septicemia. Poor patient compliance with the recommended regimen for catheter care was suspected. Thus, the overall rate of catheter-related infection was 1.6 per 1,000 days. Guidelines are discussed for removal of the catheter for suspected catheter-related infection.