Risk of Bacteremia in Patients with Hematological and other Malignancies after Initial Placement of a Central Venous Catheter

Abstract

Widespread use of central venous access devices has made catheter-related bacteremia an important concern. Therefore, we conducted a follow-up study on the risk of bacteremia in Danish patients with hematological or other malignancies after placement of their first central venous access devise. At a Danish university hospital we identified 357 patients with hematological or other malignancies during a three-year period, 2000-2002. Data on catheter placement and bacteremias were obtained from hospital registries. Clinical data were abstracted from patients' charts. 104 patients had a hematological malignancy (hem) and 253 patients had other malignancies (solid tumor). A total of 55 patients (34/21) developed bacteremia following catheter placement. After adjustment for age, sex, and comorbidity, the relative risk of bacteremia in the hem compared with the solid tumor group was 10.8 (95%; CI, 5.8-20.1). In both groups, the central venous catheter was the most frequent focus of infection with no major difference in proportion (50% and 33%, respectively); an unknown focus was also common (50% and 19%, respectively). Patients with hematological malignancies had a 10-fold increased risk of bacteremia compared with other cancer patients and the central venous catheter was not the only important focus.