Outcomes of Hickman Catheter Salvage in Febrile Neutropenic Cancer Patients With<i>Staphylococcus aureus</i>Bacteremia

Kim, Sung-Han; Kang, Cheol-In; Kim, Hong Bin; Youn, Sung-Soo; Oh, Myoung Don; Kim, Eui-Chong; Park, Seon-Yang; Kim, Byoung-Kook; Choe, Kuk Jin

doi:10.1086/502157

Cited by 40 publications

(20 citation statements)

References 25 publications

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“…Vancomycin is the most studied antibiotic in both a treatment and prophylactic modality 6–12,16. In our case series, vancomycin was only successful in 37.5% of cases when used as the only antibiotic in solution.…”

Section: Discussionmentioning

confidence: 64%

Clinical outcomes of antimicrobial lock solutions used in a treatment modality: a retrospective case series analysis

Bookstaver¹,

Gerrald²,

Moran³

2010

CPAA

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BackgroundAntimicrobial lock therapy (ALT) may be considered as adjunctive therapy in the treatment of catheter-related bloodstream infections (CRBSI) when catheter removal is not a favorable option.ObjectiveTo evaluate the outcomes associated with ALT as adjunctive treatment of CRBSI.MethodsThis was a 24-month retrospective case series analysis evaluating patients treated for more than 24 hours with ALT. The primary outcome was blood culture sterilization for 30 days posttherapy. The impact of ALT duration and time to initiation on central venous catheter (CVC) salvage were evaluated. Logistic regression modeled the association between ALT and sterilization rates, with a prespecified level of significance (α) of 0.1.ResultsTwenty-six cases were included in data analysis. Patients included ranged from 5 months to 82 years of age; 77% of patients were receiving total parenteral nutrition or chemotherapy. The majority of patients received vancomycin, daptomycin, or gentamicin combined with heparin in a lock solution. Blood culture sterilization was achieved in 69.2% of cases, and sterilization plus CVC retention was achieved in 11 cases (42.3%). Longer durations of ALT (≥9 days) were significantly correlated with blood culture sterilization (odds ratio = 1.367, P = 0.077).ConclusionALT used as an adjunct to systemic therapy for adequate duration in CRBSI can achieve CVC sterilization and retainment without subsequent infectious complications.

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Section: Discussionmentioning

confidence: 64%

Clinical outcomes of antimicrobial lock solutions used in a treatment modality: a retrospective case series analysis

Bookstaver¹,

Gerrald²,

Moran³

2010

CPAA

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“…Retrospective data retrieval from 01/01/00 to 01/01/07 revealed a total of 464 cuffed lines placed of which 418 were new site and 56 THDC placed using guidewire exchange from a noncuffed catheter. The phenomenon of antibiotic lock to combat bacteremia and salvage catheters has recently gained popularity with reported success (Kim, Kang, Kim, et al, 2003;Vercaigne, Zelenitsky, Findlay, Bernstein, & Penner, 2002). To ensure validity those catheters that had received such a ''line-lock'' in both groups were excluded from the study, along with tunnel-to-tunnel exchange thus leaving 362 newsite insertion and 46 guidewire exchange catheters for inclusion (total 408).…”

Section: Methodsmentioning

confidence: 99%

Inserting Tunnelled Hemodialysis Catheters Using Elective Guidewire Exchange From Nontunnelled Catheters: Is There a Greater Risk of Infection When Compared Too New-Site Replacement?

Davies¹,

Casey²,

Taylor³

et al. 2008

Journal of Radiology Nursing

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“…In particular, the catheter salvage rate of coagulase-negative Staphylococcus reaches 70-80% with intravenous antibiotics alone; thus, the use of antibiotics without catheter removal is generally recommended [182,184] (A-II). However, for catheter-related infection caused by fungi (yeasts or molds) or non-tuberculous mycobacteria (e.g., Mycobacterium chelonae , M. abscessus , or M. fortuitum ), the catheter should be removed immediately [3].…”

Section: Catheter-related Infectionsmentioning

confidence: 99%

Evidence-Based Guidelines for Empirical Therapy of Neutropenic Fever in Korea

Lee

Kim

et al. 2011

Korean J Intern Med

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Neutrophils play an important role in immunological function. Neutropenic patients are vulnerable to infection, and except fever is present, inflammatory reactions are scarce in many cases. Additionally, because infections can worsen rapidly, early evaluation and treatments are especially important in febrile neutropenic patients. In cases in which febrile neutropenia is anticipated due to anticancer chemotherapy, antibiotic prophylaxis can be used, based on the risk of infection. Antifungal prophylaxis may also be considered if long-term neutropenia or mucosal damage is expected. When fever is observed in patients suspected to have neutropenia, an adequate physical examination and blood and sputum cultures should be performed. Initial antibiotics should be chosen by considering the risk of complications following the infection; if the risk is low, oral antibiotics can be used. For initial intravenous antibiotics, monotherapy with a broad-spectrum antibiotic or combination therapy with two antibiotics is recommended. At 3-5 days after beginning the initial antibiotic therapy, the condition of the patient is assessed again to determine whether the fever has subsided or symptoms have worsened. If the patient's condition has improved, intravenous antibiotics can be replaced with oral antibiotics; if the condition has deteriorated, a change of antibiotics or addition of antifungal agents should be considered. If the causative microorganism is identified, initial antimicrobial or antifungal agents should be changed accordingly. When the cause is not detected, the initial agents should continue to be used until the neutrophil count recovers.

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Outcomes of Hickman Catheter Salvage in Febrile Neutropenic Cancer Patients WithStaphylococcus aureusBacteremia

Abstract: In neutropenic cancer patients with S. aureus bacteremia, attempted catheter salvage without antibiotic lock therapy was successful in 50% of the cases.

Cited by 40 publications

References 25 publications

Clinical outcomes of antimicrobial lock solutions used in a treatment modality: a retrospective case series analysis

Clinical outcomes of antimicrobial lock solutions used in a treatment modality: a retrospective case series analysis

Inserting Tunnelled Hemodialysis Catheters Using Elective Guidewire Exchange From Nontunnelled Catheters: Is There a Greater Risk of Infection When Compared Too New-Site Replacement?

Evidence-Based Guidelines for Empirical Therapy of Neutropenic Fever in Korea

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