1139 DIFFERENCES IN SILASTIC CATHETER RELATED INFECTION CANCER PATIENTS VS NON-CANCER PATIENTS

Abstract

Infection of indwelling silastic central venous catheters (SCVC) in pediatric patients is a common complication. A retrospective study involving 86 patients was performed to compare SCVC associated infections between children receiving chemotherapy and children without cancer. All underwent SCVC placement in the OR between 6/81-12/83. Data subsequent to the placement of 102 catheters was analyzed. Exit site swelling, previous catheter repair or occlusion were found to increase the incidence of SCVC related infection. No statistically significant differences were found in either the incidence or the location (exit site or blood) of infection in either group. The 53 pts receiving cRX exhibited a 27% (17 infect/62 catheters) infection rate (13/17 were bacteremic). There were 8.1 bacteremic episodes and 2.5 exit site infections per 100 catheter days. Similarly, the 33 non-cancer pts exhibited a 22% (9 infect/40 catheters) infection rate (6/9 were bacteremic). These pts had 8 bacteremic episodes and 4 exit site infections per 100 catheter days. However, the organisms causing sepsis in each group were different. In children without cancer, sepsis was caused only by fungus and gram positive organisms: Staph species (50%) C. albicans (33%), enterococeus and Candida (17%). Gram negative bacteremia occurred only in cancer pts: Gram negatives (23%), Staph species (46%), Strep (23%), Candida and S. aureus (8%). These data demonstrate that SCVC placement is associated with similar infection risks in both cancer and non-cancer pts, although the spectrum of organisms causing infection differs between the two groups.