Journal Article

Morbidity Associated with Long-Term Use of Totally Implantable Ports in Patients with AIDS

Pere Domingo, Angels Fontanet, Ferrán Sánchez, Luis Allende and Guillermo Vazquez

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 29, issue 2, pages 346-351
Published in print July 1999 | ISSN: 1058-4838
Published online July 1999 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/520213
Morbidity Associated with Long-Term Use of Totally Implantable Ports in Patients with AIDS

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To determine the morbidity associated with long-term use of a totally implantable central venous access device (Port-A-Cath [PAC]) in patients with AIDS, we studied 68 consecutive patients with AIDS requiring 79 such devices for long-term use, inserted over a period of 5 years. The total number of PAC-days was 20,159. At least one PAC-related complication occurred with 40 of 79 PACs (50.6% [95% confidence interval (CI): 39.6%–61.6%]), and 16 devices (20.2% [95% CI, 11.4%–29.0%]) had to be removed because of complications. Device-related infection occurred with 33 of 79 PACs (41.7% [95 CI, 30.8%–52.6%]). The predominant infection occurring with PACs was chamber infection, with an incidence of 0.16 per 100 PAC-days. The predominant organisms isolated from patients with chamber infections but also from those with device-related bacteremia were gram-positive cocci (79.4%). The presence of neutropenia (odds ratio [OR] = 9.72; 95% CI, 3.0–31.3; P < .001) and a CD4 cell count lower than 0.025 × 109/L (OR = 6.14; 95% CI, 1.9–19.2; P = .002) were independent predictors of infection. The antibiotic lock technique was associated with decreased device loss when compared with isolated systemic antibiotic therapy (OR = 0.05; 95% CI, 0.0–0.59; P = .008). This technique may be useful to treat PAC infection in patients with AIDS, for whom the risk of PAC-related complications is very high.

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

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