1. ¹Department of Medical Oncology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
2. ²Department of Medical Oncology, Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
3. ³Department of Medical Oncology, Erasmus Medical Center, Rotterdam, The Netherlands
4. ⁴Department of Medical Oncology, VU Medical Center, Amsterdam, The Netherlands
5. ⁵Department of Medical Oncology, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
6. ⁶Department of Medical Oncology, Medical Spectrum Twente, Enschede, The Netherlands
7. ⁷Department of Medical Oncology, University Hospital Maastricht, Maastricht, The Netherlands
8. ⁸Department of Medical Oncology, University Medical Center Utrecht, Utrecht, The Netherlands
9. ⁹Department of Medical Oncology, Leiden University Medical Center, Leiden, The Netherlands

Correspondence: Dr WTA van der Graaf, Department of Medical Oncology, Radboud University Nijmegen Medical Center, PO Box 9101, Nijmegen 6500 HB, The Netherlands. E-mail: w.vandergraaf@onco.umcn.nl

Received 1 October 2007; Revised 20 May 2008; Accepted 23 May 2008; Published online 14 July 2008.

Abstract

Neutropenia following high-dose chemotherapy leads to a high incidence of infectious complications, of which central venous catheter-related infections predominate. Catheter-related infections and associated risk factors in 392 patients participating in a randomized adjuvant breast cancer trial and assigned to receive high-dose chemotherapy and peripheral stem-cell reinfusion were evaluated. Median catheter dwell time was 25 days (range 1–141). Catheter-related infections were seen in 28.3% of patients (11 infections per 1000 catheter-days). Coagulase-negative staphylococci were found in 104 of 186 positive blood cultures (56%). No systemic fungal infections occurred. Cox regression analysis showed that duration of neutropenia >10 days (P=0.04), using the catheter for both stem-cell apheresis and high-dose chemotherapy (P=<0.01), and use of total parenteral nutrition (TPN, P=0.04) were predictive for catheter-related infections. In conclusion, a high incidence of catheter-related infections after high-dose chemotherapy was seen related to duration of neutropenia, use of the catheter for both stem-cell apheresis and high-dose chemotherapy, and use of TPN. Selective use and choice of catheters could lead to a substantial reduction of catheter-related infectious complications.