Central venous catheter-related bacteremia due to gram-negative bacilli: significance of catheter removal in preventing relapse.

摘要: OBJECTIVE: To study the characteristics of catheter-related, gram-negative bacteremia (GNB) and role central venous catheter (CVC) removal. DESIGN: This retrospective involved a search microbiological department records CVC blood cultures patients' medical records. SETTING: University Texas M. D. Anderson Cancer Center, tertiary-care hospital in Houston, Texas. PATIENTS: Patients with cancer who had catheter-related GNB, defined as (1) positive tip culture at least 15 colony-forming units semiquantitatively, (2) isolation same organism from peripheral cultures, (3) no other source for except CVC, (4) clinical manifestations infection (fever or chills). RESULTS: Between January 1990 December 1996, 72 cases GNB were available review. Most patients (67; 93%) their CVCs removed response to bacteremia. Few (5; 7%) retained treated appropriate antibiotics. When removed, only 1 patient (1%) relapsed organism, whereas all 5 after having responded (P <.001). The most commonly isolated organisms Enterobacter, Klebsiella, Stenotrophomonas, Pseudomonas, Acinetobacter species. Catheter removal within hours onset was independent protective factor against relapse (odds ratio, 0.13; 95% confidence interval, 0.02-0.75; P=.02). CONCLUSION: In documented should be 48 prevent relapse.