Incidence of non-tunnelled central venous catheter-related infections in oncologic patients receiving chemotherapy in an outpatient setting

Madhukumar P, Loh GY, Maung ZT, Chua FS, Chen JJ
Correspondence: Dr Preetha Madhukumar, preetha@nccs.com.sg

ABSTRACT
Introduction Central venous catheters (CVCs) are becoming more popular for delivery of outpatient courses of intravenous therapy such as chemotherapy and long-term antibiotics. The incidence of non-tunnelled type CVC-related infections in patients with solid tumours receiving chemotherapy in an ambulatory setting has not been well studied. We aimed to determine the baseline data on CVC-related infections in this retrospective study conducted from January 2005 to December 2007.
Methods Data on cancer patients with CVCs inserted as outpatients at National Cancer Centre Singapore over a three-year period were collected and analysed retrospectively. Data retrieved from medical records included patients’ demographics, the number of catheter days, cancer type and other medical illnesses. Definitions from the Centre for Disease Control and Prevention for CVC-related infections were used. For data analysis, graphical and quantitative techniques were employed.
Results A total of 88 CVCs were inserted during the study period, with a total of 11,541 catheter days (median 114; range 2–510 days). Infection rate was 0.87 per 1,000 catheter days. The risk of infection was higher when catheters were left in situ for longer periods of time and in patients with solid tumours.
Conclusion The infection rate for non-tunnelled type CVCs is low in our centre. Hence, its use for chemotherapy on an outpatient basis is relatively safe and convenient in oncologic patients.

Keywords: ambulatory care, central venous catheter, chemotherapy, infection
Singapore Med J 2012; 53(8): 513–516