Hickman catheter-associated infections after haematopoietic stem cell transplantation and their relationship with period elapsing from catheter implantation to transplantation

• Published in: Bone marrow transplantation (Basingstoke) Vol. 43; no. S1; p. S339
• Main Authors: Seixas, M. Ruiz, Moncada, M. Vazquez, Lopez, R. Lopez, Tocino, I. Espigado, Malaver, F.J. Marquez
• Format: Journal Article
• Language: English
• Published: Nature Publishing Group 01-03-2009
• Subjects: Bacterial infections; Central venous catheters; Complications and side effects; Health aspects; Hematopoietic stem cells; Patient outcomes; Prevention; Risk factors; Transplantation; Spain
• ISSN: 0268-3369

Introduction: Haematopoietic stem cell transplantation (HSCT) requires long-term implantation of a central venous catheter, which becomes a significant risk factor for bacterial infections. This has serious consequences for the patient, the family and the health system. Our experience with patients carrying Hickman catheters prompts us to suspect the relationship between the time elapsing between catheter implantation prior to HSCT and the onset of infections. Hypothesis: Patients receiving HSCT with a Hickman catheter implanted more than 20 days before transplantation show a lower incidence of catheter-associated infections than patients who were implanted the catheter within the 20 days previous to transplantation. Objective: To analyze the relationship between Hickman catheterassociated infections and the period of time elapsing from catheter implantation to transplantation. Methods: Prospective observational cohort study. We studied two groups of patients undergoing HSCT, distributed according to the date of catheter implantation. We used direct observation and specific records. The study lasted until completion of a sample of 80-100 patients. Results: After study of 19 patients, 52.6% with a catheter implanted more than 20 days prior to transplantation and 47.3% less than 20 days, we observed that in the first group 50% of the infections were related to the catheter. On average fever occurred two days after transplantation and lasted for 6.3 days. An average of 3.66 antibiotics was administered for a period of 11.5 days. Prolonged hospital stay of 4,83 days is attributable to the infection. As regards the second group, we observe 57.1% of catheter-associated infections. On average, fever appeared 2.1 days after transplantation and lasted for 9.1 days. An average of 4.57 antibiotics was administered per patient for a period of 20.5 days. Prolonged hospital stay was of 14.7 days. Conclusion: This is a small sample to obtain any conclusions. It seems that the results so far obtained confirm our hypothesis, that is, catheters implanted within 20 days prior to HSCT have a higher prevalence of associated complications (fever, more antibiotics therapy, prolonged hospital stay, higher cost, etc).