A PROSPECTIVE STUDY OF THE INFECTIOUS COMPLICATIONS OF BROVIAC CATHETERS IN ONCOLOGY PATIENTS

Abstract

Prolonged chemotherapy in oncology patients has been facilitated by permanent indwelling central venous catheters. This study prospectively evaluated infectious complications associated with Broviac catheters in children with malignancies. Catheters in infected patients were not removed unless antimicrobials failed to eradicate the infection. From June 1981 to September 1983, 21 oncology patients (ages 2 months to 14 years) had Broviac catheters placed and maintained at this hospital. There were 660 weeks of indwelling catheter time and single catheters have been maintained for up to 78 weeks. A total of 74 febrile episodes occurred in 20/21 patients. Bacteremia was detected in 9/74 (11%) febrile episodes. No patient with a positive blood culture required catheter removal or had a second bacteremia with the same organism. The organisms included S. epidermidis (4), S. aureus (1), Micrococcus (1), and K. pneumonia (2). The rate of catheter associated sepsis was one bacteremia for every 83 weeks of catheter time. Local infections near the catheter occurred in 3/21 patients and none were associated with bacteremia. Broviac catheters are valuable aids in management of oncology patients. Although these children are at high risk, serious infections were not a major problem. In addition, this data suggests that septic patients with Broviac catheters do not need to have their catheters routinely removed for effective therapy of bacterial sepsis.