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Venous access ports. Prospective study to analyse use-related complications

Abstract number: 1734_157

Serrera A., Alonso M., del Pozo J.L., Hernaez S., Martinez A., Bilbao I., Aguinaga A., Ramos A., Leiva J.

Objectives: Venous access ports (VAP) are used in patients receiving long parenteral treatments. The aim of this prospective and observational study was to analyse the complications of VAP use, and to describe the role of different culture techniques for diagnosing VAP-related infection.

Methods: Over a 12-month period all VAPs removed in our hospital were microbiologically examined by the following procedures: culture of the catheter tip (sonication method). Culture of the internal lumen of the port (chamber swabbing and septum sonication). Besides, a macroscopic analysis with search for deposits inside the reservoir was performed. We also analysed the records of all patients (age, sex, clinical diagnosis, underlying conditions, date of VAP insertion and removal, number of days in use, reasons for removal and all significant events during treatment).

Results: From August 2005 to the end of July 2006, 121 VAPs were removed from 121 patients (median age, 48; range, 4 81 years). The mean duration of implantation of the VAPs was 618 days (range, 0 3301 days). The mean VAP uses were 7 (range, 0–45 uses). VAPs were removed at the end of treatment in 99 cases; with 8% of VAP positive cultures. S. epidermidis was the most frequent isolated microorganism (66.6%). Eleven VAPs (9.1%) were removed from 11 patients because of suspected VAP-related bloodstream infection. Septum culture was positive in 90.9% of the patients while catheter tip culture was only 60% positive. The isolated microorganisms were as follows: S. aureus (3 patients), yeasts (3), Gram-negative bacilli (3), coagulase-negative staphylococci (1), and A. fumigatus (1). The overall incidence of VAP-related bloodstream infection was 0.11/1000 VAP-days. Eleven patients had a VAP removed because of mechanical complications; with 50% of positive VAP cultures. S. epidermidis was the most common isolated microorganism (87.5%). The overall incidence of VAP-related mechanical complication was 0.11/1000 VAP-days. In 26 patients (21.49%) we found deposits in the internal lumen of the reservoir (84.6% in end-use removal, 7.6% in VAP-infection and 7.6% in VAP-mechanical complication).

Conclusions: Incidence of associated VAP-use complications is low in our hospital. On the basis of data from the present study, it looks that the reservoir is the key piece of the catheter for the diagnosis of VAP-related infections. S. epidermidis might play a role in the genesis of some mechanical complications.

Session Details

Date: 31/03/2007
Time: 00:00-00:00
Session name: European Society of Clinical Microbiology and Infectious Diseases
Subject:
Location: ICC, Munich, Germany
Presentation type:
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