THE RISK OF INFECTION ASSOCIATED WITH INTRAARTERIAL CATHETERS FOR CANCER-CHEMOTHERAPY

OBJECTIVE: To determine the frequency of, and risk factors for, infect ions associated with intra-arterial catheters used for cancer chemothe rapy. METHODS: Between September 1992 and September 1995, we conducted a surveillance study of all 807 intra-arterial catheters placed for c hemotherapy at our center. The insertion site was disinfected with pov idone iodine and alcohol, and the arterial catheter was placed using m aximal sterile barrier precautions. Upon removal, all intravascular se gments were submitted for semiquantitative culture. RESULTS: No episod es of catheter-related bloodstream infection (95% confidence interval [CI95], 0%-1.6% were observed. However, the risk of colonization (>15 colony-forming units) of arterial catheters was 15% (CI95, 12%-17%). R etrospective risk-factor analysis conducted on 224 intra-arterial cath eters placed for chemotherapy in 1993 showed that colonization was ass ociated significantly with duration of catheterization (median of 1 da y for culture-negative catheters vs median of 4 days for culture-posit ive catheters, P<.001). Age, gender, prior radiotherapy, underlying ca ncer, neutropenia, and hypoalbuminemia were not associated with cathet er colonization. CONCLUSION: Intra-arterial catheters for cancer chemo therapy placed under maximal sterile barrier precautions for a short p eriod of time are associated with a very low risk of bloodstream infec tion (Infect Control Hosp Epidemiol 1998;19:640-642).