Key result
Non-tunnelled CVCs for IV iloprost in PH yield a low infection rate of ~1.3 per thousand catheter days.
Why the study?
Long-term central venous catheters in patients with pre-capillary pulmonary hypertension treated with intravenous iloprost expose patients to infectious complications, but incidence and bacterial spectrum data are limited.
What is the incidence and microbiological spectrum of catheter-related infections in ambulatory pulmonary hypertension patients treated with continuous intravenous iloprost via non-tunnelled central venous catheters?
Observational (n=15)
No
What is the incidence and microbiological spectrum of catheter-related infections in ambulatory pulmonary hypertension patients treated with continuous intravenous iloprost via non-tunnelled central venous catheters?
The incidence of catheter-related infections in pulmonary hypertension patients using long-term non-tunnelled central venous catheters for iloprost is low, but frequently involves uncommon pathogens.
Answers are grounded in this paper and cite their sources.
Supports viability of non-tunnelled catheters for iloprost in select patients; leaves open prospective validation of rates and pathogens.
Background: Intravenous prostanoid therapy is one cornerstone of therapy for patients with pre-capillary pulmonary hypertension (PH). Long-term central venous catheters expose patients to infectious complications. Objectives: We report the incidence of catheter-related infection (CRI) and the spectrum of bacteria for ambulatory PH patients treated with iloprost via non-tunnelled central venous catheters from our Swiss referral centre in Zurich. Methods: Data from 15 PH patients treated with intravenous iloprost between May 2000 and June 2012 were reviewed. Results: We found 11 CRI in 4 cases by two different organisms. Pathogens found were Brevibacterium (55%), Micrococcus luteus (18%), coagulase-negative Staphylococcus (9%) and Staphylococcus aureus (9%), as well as unusual organisms such as Agrobacterium tumefaciens or Delftia tsuruhatensis. The overall CRI rate was 1.28 per 1,000 catheter days, or 0.47 per year. Conclusions: The incidence of CRI using long-term, non-tunnelled central venous catheters in PH patients treated with iloprost is low. Uncommon, rare pathogens causing CRI were found in a substantial number of patients.
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Keusch et al. (2013) conducted an observational in pulmonary hypertension (n=15). Non-tunnelled central venous catheters for intravenous iloprost was evaluated on Catheter-related infection (CRI) rate. Long-term non-tunnelled central venous catheters for intravenous iloprost in pulmonary hypertension patients had a low catheter-related infection rate of 1.28 per 1,000 catheter days.
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