Long-term central venous catheter infection in HIV-infected and cancer patients: A multicenter cohort study

OBJECTIVES: To evaluate and compare the risk of longterm central venous cat heter (CVC) infection in human immunodeficiency virus (HIV)-infected and ca ncer patients. DESIGN: Prospective multicenter cohort study based on active surveillance o f long-term CVC manipulations and patient outcome over a 6-month period. SETTING: Services of infectious diseases and oncology of 12 university hosp itals in Paris, France. PARTICIPANTS: In 1995, all HIV and cancer patients with solid malignancy we re included at the time of long-term CVC implantation. RESULTS: Overall, 31.6% of long-term CVC infections were identified in 32% of 201 HIV and 5% of 255 cancer patients. Most were associated with bactere mia, most commonly coagulase-negative staphylococci. The long-term CVC time -related infection risk was greater in HIV than in cancer patients (3.78 vs 0.39 infections per 1,000 long-term CVC days; P<.001). The independent ris k factors of long-term CVC infection were as follows: in HIV patients, freq uency of long-term CVC handling and neutropenia; in cancer patients, poor K arnofsky performance status; in both HIV and cancer patients, recent histor y of bacterial infection. The risk of long-term CVC infection was similar f or tunneled catheters and venous access ports in each population. CONCLUSIONS: Prevention of long-term CVC infection should focus first on be tter sterile precautions while handling longterm CVC, especially in HIV pat ients who have frequent and daily use of the long-term CVC.