Journal Article

Venous Access Port-Related Bacteremia in Patients with Acquired Immunodeficiency Syndrome or Cancer: The Reservoir as a Diagnostic and Therapeutic Tool

Pascale Longuet, Marie Cécile Douard, Guillaume Arlet, Jean Michel Molina, Catherine Benoit and Catherine Leport

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 32, issue 12, pages 1776-1783
Published in print June 2001 | ISSN: 1058-4838
Published online June 2001 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/320746
Venous Access Port-Related Bacteremia in Patients with Acquired Immunodeficiency Syndrome or Cancer: The Reservoir as a Diagnostic and Therapeutic Tool

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To describe the rate of response to an antibiotic-lock technique (ALT) in the treatment of venous access port (VAP)-related bacteremia and to analyze the role of the reservoir in the persistence of infection, we reported the data from 12 human immunodeficiency virus-infected and 8 oncologic patients with VAP-related bacteremia. The ALT consisted of intracatheter delivery of antibiotics and was associated with a systemic antibiotic infusion. We monitored clinical manifestations and performed qualitative and quantitative blood cultures during and at the end of the treatment. Four patients had catheters removed before antibiotic treatment. Of the 16 patients who were treated with the ALT, 5 (31%) were cured, as determined by negative cultures of blood and of samples from the catheter; 2 (12.5%) were cured but had recurrent infection with another microorganism; and 9 (56%) had persistent positive cultures of blood and of samples from the tip, reservoir, or both of the VAP. Limited efficacy of the ALT might be explained by the presence of deposits of fibrin that include clusters of bacteria inside the reservoir of the port.

Journal Article.  4468 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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