Hickman-Broviac catheter-related infections in children with malignancies

Infectious complications are frequently encountered following Hickman-Brovi ac (H-B) catheter insertion. The medical records of 164 children with malig nancies who underwent H-B catheter insertion from March 1, 1988 to December 31, 1997 were reviewed retrospectively. During a 35,697 catheter-day perio d, 77 catheter-related infections occurred, including 50 catheter-insertion -site infections and 27 bloodstream infections. The risk for the developmen t of catheter-related infections was 2.15 per 1000 catheter-days (1.4 and 0 .75 per 1000 catheter-days for catheter-insertion-site and bloodstream infe ctions, respectively). In 17 (63%) of 27 episodes of bloodstream infections , antimicrobial treatment controlled the infection without catheter removal . A previous catheter-insertion-site infection caused by Staphylococcus epi dermidis (p=0.01), the occurrence of mechanical catheter complications (p=0 .007), and a normal coagulation status of the host (p=0.03) were significan tly associated with the development of catheter-related bloodstream infecti ons. H-B catheters remain important in pediatric oncology. Due to the signi ficant morbidity associated with the development of catheter-related bloods tream infections, risk factors found to increase the Incidence rate of such infections must be identified and properly managed.