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Is venous access port inner surface colonisation related with port obstruction?

Abstract number: P1082

Alonso M., Martinez A., Serrera A., Ramos A., Bilbao J.I., Portillo M., Leiva J., del Pozo J.L.

Objectives: Venous acces ports (VAP) are used in patients receiving long parenteral therapy. However, use of these devices is associated with infectious and mechanical complications. One of the most common causes of mechanical failure is catheter lumen occlusion. This complication may lead to the removal of the port. Although precipitation of drugs and blood clots can obstruct the device, we propose here that colonisation of the port inner surface may be related to port obstruction. The aim of this study was to analyse if port colonisation and obstruction were associated in a significative way.

Methods: We performed a 27 months prospective study on all the removed VAPs of our hospital. We analysed reasons for removal and we cultured all the removed ports (catheter tip and septum culture after a vortexing-sonication procedure). We compared colonisation ratios on the group of patients whose VAPs were removed because of the obstruction (group 1) and the group of patients whose VAPs were removed because of end of use or because of a mechanical complication other than obstruction (group 2). Patients with port-related infections were excluded. The cut-off to consider the ports to be colonised was >1000 cfu/ml for both cultures (catheter and septum). Differences were statistically analysed using the chi-square test.

Results: From August 2005 to October 2007, 240 VAPs were removed from 240 patients. Ports were removed due to end of use in 187 (77.9%) cases, 34 (14.2%) ports were removed because of infectious complications and 19 (7.9%) because of mechanical complications. Seven of the ports were removed due to obstruction (group 1) and 197 because end of use (group 2). Colonisation rates were 3/7 (42.9%) and 16/197 (8.1%) in groups 1 and 2 respectively. Differences were statistically significative with a p value of <0.019. Coagulase-negative staphylococci were the most frequent isolated microorganisms, followed by Candida species.

Conclusions: Data from this study suggest that port colonisation may play a role in the genesis of port obstruction. Antibiotic lock therapy might be useful in this scenario to try to avoid removal because of obstruction. However, more prospective studies are warranted to address this important issue.

Session Details

Date: 19/04/2008
Time: 00:00-00:00
Session name: 18th European Congress of Clinical Microbiology and Infectious Diseases
Subject:
Location: Barcelona, Spain
Presentation type:
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