Abstract
Nineteen children (median age 2 yrs) undergoing chemotherapy for malignancies had indwelling silastic Broviac catheters (BC) placed in the superior vena cava to provide vascular access. The BC were in place for a total of 85 patient-months (mean 4.5 mos/patient). There were 8 episodes of BC-related bacteremic infections (1 episode/10.6 patient-months). The infections occurred from 3wks-6 mos after BC insertion (median 7 wks ). Presenting symptoms included fever in all cases (often associated with irrigation of the BC), chills, and peripheral vascular instability. The bacteremia was not associated with neutropenia or other foci of infection. The infecting organisms were Klebsiella pneumoniae (2), Staphylococcus epidermidis (2), Staphylococcus aureus, Pseudomonas aeruginosa, E. coli, Enterobacter cloacae, Candida tropicalis, and an unidentified gram-negative rod. Cultures drawn from the BC were positive in all cases and those drawn from a peripheral vein in 6/8 (75%). Antimicrobial therapy (Rx) alone without BC removal successfully cured the infection in 5 of 6 cases (83%). The one medical failure had bacteremia with 3 different organisms which cleared only after BC removal. One child with Candida infection had BC removal without antimicrobial Rx. One child had BC removal for reasons unrelated to infection. There were no other infection related complications. Most BC infections may initially be treated with antimicrobial Rx alone without BC removal.
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Shapiro, E., Spiegelman, K., Wald, E. et al. 870 CATHETER RELATED BACTEREMIA IN ONCOLOGY PATIENTS WITH INDWELLING BROVIAC CATHETERS. Pediatr Res 15 (Suppl 4), 587 (1981). https://doi.org/10.1203/00006450-198104001-00895
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DOI: https://doi.org/10.1203/00006450-198104001-00895