Infections on implantable central venous access systems in patients with AIDS.

Objectives - Infections on implantable central venous access systems are su pposed to be more common in patients with AIDS than in the general populati on. We wanted to assess this finding in our population of HIV infected pati ents. Material and methods - We report from a retrospective study over ten years, of 31 cases of infections on implantable central venous access system in 2 2 subjects with AIDS. Results - Theses infections were detected approximately 770 days after the device was set in situ. The responsible microorganisms were: Staphylococcus epidermidis (23 times), Staphylococcus aureus (five times), Enterococcus f aecalis (once), Gram-negative bacteria (five times), Candida albicans (once ) The infections were confirmed in 13 cases by positive blood samples and c ultures taken from the system. It was successfully treated in 22 cases, alt hough the implantable central venous access system had to be removed by six subjects. A recurrence of the same germ was staded three times and six pat ients died. Conclusion - Our study shows the same bacterian profile as those reported b y other studies in the literature. The contributing factors analyzed are th ose already described (immunosuppression, frequency of use, length of hospi talization). Finally as shown in this study if intravenous antibiotic thera py is an absolute necessity, removal of the implantable central venous acce ss system is not systematically required. (C) 1999 Elsevier, Paris.