Venous access port-related bacteremia in patients with acquired immunodeficiency syndrome or cancer: The reservoir as a diagnostic and therapeutic tool

To describe the rate of response to an antibiotic-lock technique (ALT) in t he treatment of venous access port (VAP)-related bacteremia and to analyze the role of the reservoir in the persistence of infection, we reported the data from 12 human immunodeficiency virus-infected and 8 oncologic patients with VAP-related bacteremia. The ALT consisted of intracatheter delivery o f antibiotics and was associated with a systemic antibiotic infusion. We mo nitored clinical manifestations and performed qualitative and quantitative blood cultures during and at the end of the treatment. Four patients had ca theters removed before antibiotic treatment. Of the 16 patients who were tr eated with the ALT, 5 (31%) were cured, as determined by negative cultures of blood and of samples from the catheter; 2 (12.5%) were cured but had rec urrent infection with another microorganism; and 9 (56%) had persistent pos itive cultures of blood and of samples from the tip, reservoir, or both of the VAP. Limited efficacy of the ALT might be explained by the presence of deposits of fibrin that include clusters of bacteria inside the reservoir o f the port.