Morbidity associated with central venous catheter-use in a cohort of 212 hospitalized subjects with HIV infection

Technical complications and nosocomial bloodstream infections associated wi th short-term central venous catheterization remain a heavy burden in terms of morbidity mortality and cost in HIV-positive subjects. Between 1994 and 1997, 327 central venous catheters (CVCs) inserted in 212 patients for a t otal of 5005 catheter days were investigated. Forty-two technical complicat ions (13%) occurred in 40 patients. Logistic regression analysis revealed t hat a high APACHE III score was associated with development of CVC-related complications (P = 0.01). One hundred and eight of 327 CVCs (33%) were susp ected as being infected. However only 61 episodes (61/327, 19%) were finall y diagnosed as CVC-related sepsis. Three variables affecting the rate of CV C-related sepsis were identified: 1) administration of TPS (P = 0.01); 2) l ow number of circulating CD4+ cells (P = 0.04); 3) high APACHE III score (P = 0.04). Doctors responsible for AIDS patients should carefully consider t he relative risks and benefits of CVC insertion in an individual patient. ( C) 2000 The Hospital Infection Society.