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Post-Transplant Events

Factors influencing catheter-related infections in the Dutch multicenter study on high-dose chemotherapy followed by peripheral SCT in high-risk breast cancer patients

Bone Marrow Transplantation volume 42, pages 475–481 (2008)Cite this article

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.

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Acknowledgements

This work was supported by a grant from the Dutch College for Healthcare Assurances (CVZ).

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Authors and Affiliations

  1. Department of Medical Oncology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands

    P Nieboer, E G E de Vries, N H Mulder & H M Boezen

  2. Department of Medical Oncology, Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands

    S Rodenhuis

  3. Department of Medical Oncology, Erasmus Medical Center, Rotterdam, The Netherlands

    M Bontenbal

  4. Department of Medical Oncology, VU Medical Center, Amsterdam, The Netherlands

    E van der Wall

  5. Department of Medical Oncology, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands

    Q G van Hoesel & W T A van der Graaf

  6. Department of Medical Oncology, Medical Spectrum Twente, Enschede, The Netherlands

    W M Smit

  7. Department of Medical Oncology, University Hospital Maastricht, Maastricht, The Netherlands

    P Hupperets

  8. Department of Medical Oncology, University Medical Center Utrecht, Utrecht, The Netherlands

    E E Voest

  9. Department of Medical Oncology, Leiden University Medical Center, Leiden, The Netherlands

    M A Nooij

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  1. P Nieboer
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Correspondence to W T A van der Graaf.

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Nieboer, P., de Vries, E., Mulder, N. et al. Factors influencing catheter-related infections in the Dutch multicenter study on high-dose chemotherapy followed by peripheral SCT in high-risk breast cancer patients. Bone Marrow Transplant 42, 475–481 (2008). https://doi.org/10.1038/bmt.2008.195

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