INFECTIONS ASSOCIATED WITH TOTALLY IMPLANTABLE VENOUS ACCESS DEVICES (TIVAD) IN HUMAN IMMUNODEFICIENCY VIRUS-INFECTED PATIENTS

We report on a retrospective study evaluating infectious morbidity ass ociated with totally implantable venous access devices (TIVAD) (Port-A -Cath) in HIV-infected patients. This study of 84 consecutive HIV-infe cted patients requiring 89 TIVAD between January 1990 and October 1993 was performed in the Department of Infectious Diseases Hopital de l'I nstitut Pasteur, Paris, France. The total number of catheter days was 11,595. Eighteen of 89 patients with TIVAD (20%) were infected, causin g 25 infectious events (25/89: 28%) among 17 different patients (17/84 : 20%). The infection rate was 0.22 per 100 catheter days. Mean onset of infection was 82 days. Twenty microorganisms were isolated: Staphyl ococcus aureus in eight cases (40%), coagulase-negative Staphylococcus in six cases (30%), Streptococcus D faecalis in one case; Gram-negati ve bacilli were found in five cases (25%). All patients received an in travenous antibiotherapy combined with a local lock treatment in eight cases. Nine TIVAD removals were performed. One death was related to t he TIVAD infection. No additional predisposing factor for infection wa s identified other than the implied condition of the HIV infection, Th e population and material in this study were homogeneous. The TIVAD in fection rate was comparable to other published reports. Prospective ev aluation comparing tunneled catheter and TIVAD in HIV-infected patient s is needed.