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

Abstract

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.