Clinical Predictors of Port Infections in Adult Patients with Hematologic Malignancies

Zhang, Shunqing; Kobayashi, Katsuhiro; Faridnia, Masoud; Skummer, P.; Zhang, Dianbo; Karmel, M.

doi:10.1016/j.jvir.2018.04.014

Cited by 21 publications

(16 citation statements)

References 31 publications

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“…The combination of preoperatively increased CRP and decreased serum albumin levels (i.e., Glasgow Prognostic Score) was strongly associated with perioperative and postoperative central venous catheter-related bloodstream infection in colorectal cancer patients receiving intravenous parenteral nutrition [ 175 ]. Similarly, hypoalbuminemia at the time of port placement was a predictor of early port infections in adult patients with hematologic malignancies [ 176 ].…”

Section: Hypoalbuminemia and Prognosis In Infectionsmentioning

confidence: 99%

Hypoalbuminemia as Surrogate and Culprit of Infections

Wiedermann¹

2021

IJMS

155

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Hypoalbuminemia is associated with the acquisition and severity of infectious diseases, and intact innate and adaptive immune responses depend on albumin. Albumin oxidation and breakdown affect interactions with bioactive lipid mediators that play important roles in antimicrobial defense and repair. There is bio-mechanistic plausibility for a causal link between hypoalbuminemia and increased risks of primary and secondary infections. Serum albumin levels have prognostic value for complications in viral, bacterial and fungal infections, and for infectious complications of non-infective chronic conditions. Hypoalbuminemia predicts the development of healthcare-associated infections, particularly with Clostridium difficile. In coronavirus disease 2019, hypoalbuminemia correlates with viral load and degree of acute lung injury and organ dysfunction. Non-oncotic properties of albumin affect the pharmacokinetics and pharmacodynamics of antimicrobials. Low serum albumin is associated with inadequate antimicrobial treatment. Infusion of human albumin solution (HAS) supplements endogenous albumin in patients with cirrhosis of the liver and effectively supported antimicrobial therapy in randomized controlled trials (RCTs). Evidence of the beneficial effects of HAS on infections in hypoalbuminemic patients without cirrhosis is largely observational. Prospective RCTs are underway and, if hypotheses are confirmed, could lead to changes in clinical practice for the management of hypoalbuminemic patients with infections or at risk of infectious complications.

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Section: Hypoalbuminemia and Prognosis In Infectionsmentioning

confidence: 99%

Hypoalbuminemia as Surrogate and Culprit of Infections

Wiedermann¹

2021

IJMS

155

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“…Its reduction will cause low host immunity, delayed repair of microcirculatory mucosal injury, and increased infection [48] . A retrospective chart review confirmed that hypoalbuminemia is a clinical predictor of early infection in HMs patients [49] . In this study, multivariate logistic showed that hypoalbuminemia was an independent risk factor for subsequent infection after CR-GNB colonization and accounted for 1 point in our predictive scoring model.…”

Section: Discussionmentioning

confidence: 84%

A Novel Risk Predictive Scoring Model For Predicting Subsequent Infection After Carbapenem-Resistant Gram-Negative Bacteria Colonization In Hematological Malignancies Patients

Qian

Huang

et al. 2021

Preprint

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PurposeTo investigate the high-risk factors associated with the increased vulnerability for subsequent clinical infection in Carbapenem-resistant Gram-negative bacteria (CR-GNB) colonized hematological malignancies (HMs) patients, and build a statistical model to predict subsequent infection.MethodAll adult HMs patients with positive anal swab culture for CR-GNB between January 2018 and June 2020 were prospectively followed to assess for any subsequent CR-GNB infections and to investigate the risk factors and clinical features of subsequent infection.ResultsA total of 392 HMs patients were enrolled. Of them, 46.7% developed a subsequent clinical infection, and 42 (10.7%) were confirmed infection and 141 (36%) were clinically diagnosed infection. Klebsiella pneumoniae was the dominant species. The overall mortality rate of patients colonized and infected with CR-GNB was 8.6% and 43.7%. A multivariate analysis showed that remission induction chemotherapy, the duration of agranulocytosis, mucositis, and hypoalbuminemia were significant predictors of subsequent infection after CR-GNB colonization. According to our novel risk predictive scoring model, the high-risk group were > 3 times more likely to develop a subsequent infection in comparison with the low-risk group.ConclusionOur risk predictive scoring model can early and accurately predict subsequent infection in HMs patients with CR-GNB colonization. Early administration of CR-GNB-targeted empirical therapy in the high-risk group is strongly recommended to decrease their mortality.

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“…On multivariate analysis, TP, antibiotic therapy within one week before PORT insertion, and chemotherapy within one week after PORT insertion were independently associated with CLABSI. Previous studies showed that low WBC count, low platelet count, inpatient, hypoalbuminemia, and combined with other operations were the risk factors associated with CLABSI [14][15][16][17]. Due to the different settings of the studies, there was no consensus regarding the risk factors for CLABSI, and the present study added three potential risk factors, which may be useful in prevention of CLABSI in clinical practice.…”

Section: Discussionmentioning

confidence: 92%

“…Nutritional status was considered a risk factor for CLABSI, and body mass index, albumin, and TP were identi ed in previous studies [15,18]. There was no consistent conclusion on which parameter was the most useful predictor for CLABSI.…”

Section: Discussionmentioning

confidence: 99%

Predictors of central line-associated bloodstream infections in cancer patients undergoing chemotherapy through implanted venous access ports: a cross-sectional, observational study

Chen

Yamane

Kazahari

et al. 2022

Preprint

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Background: Central vascular catheters (CVCs) are superior to peripheral vascular access in chemotherapy. Central line-associated bloodstream infections (CLABSIs) are an important complication of CVCs in chemotherapy.Methods: A cross-sectional, observational study was conducted to investigate patients with implanted venous access ports (PORTs) from July 2010 to June 2021 in a teaching hospital. General conditions of the PORTs, backgrounds, and characteristics of patients were compared between CLABSI and uninfected patients to identify predictors of CLABSI.Results: A total of 566 patients with PORTs who underwent chemotherapy were enrolled in this study, with CLABSI identified in 41 patients, for a total of 436,597 catheter-days. The median duration of PORT use was 26 days vs 494 days (p < 0.001) in the CLABSI and uninfected groups, respectively. There were no significant differences in tumor classification, staging, white blood cell (WBC) count, neutrophil proportion, lymphocyte proportion, albumin, C-reactive protein (CRP), and performance status between the CLABSI and uninfected groups. Multivariable analysis showed that total protein, antibiotic usage before one week, and immediate use of PORT were independently associated with CLABSI, and their odds ratios (ORs) were 1.84 (95% confidence interval (CI) 1.08, 3.13), 3.34 (95%CI 1.20, 9.32), and 2.37 (95%CI 1.01, 5.54), respectively.Conclusions: PORT implantation should be avoided in patients who have received antibiotic treatment or had antibiotic treatment episodes within one week, especially for those with low serum total protein levels.

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Clinical Predictors of Port Infections in Adult Patients with Hematologic Malignancies

Cited by 21 publications

References 31 publications

Hypoalbuminemia as Surrogate and Culprit of Infections

Hypoalbuminemia as Surrogate and Culprit of Infections

A Novel Risk Predictive Scoring Model For Predicting Subsequent Infection After Carbapenem-Resistant Gram-Negative Bacteria Colonization In Hematological Malignancies Patients

Predictors of central line-associated bloodstream infections in cancer patients undergoing chemotherapy through implanted venous access ports: a cross-sectional, observational study

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