1626 - Chlorhexidine for the prevention of bloodstream infection (BSI) associated with permanently implantable venous ports (port-a) in solid cancer patien...
|Date||28 September 2012|
|Event||ESMO Congress 2012|
|Topics|| Supportive Care
H. Kao1, I. Chen1, S. Chang2, M. Hong2, S. Chien3, F. Hu4, C. Hsu5, K. Yeh6
Chlorhexidine can prevent surgical wound infection and BSI related to central venous catheters, but its effects on preventing BSI associated with Port-A use in cancer patients remain obscure.Methods
Solid cancer patients who were implanted with a Port-A since Dec 2010 at our department for systemic anti-cancer therapies were prospectively followed for the occurrence of Port-A-associated BSI (PABSI), defined as BSI without other identifiable infection foci. All patients used chlorhexidine for Port-A topical care. The time to first PABSI in this cohort was compared with a previous cohort for whom iodine was used as topical anti-septic. Risk factors of PABSI were analyzed by Cox proportional hazards model.Results
The baseline characteristics of the two cohorts were similar (table). The PABSI incidence was 0.740 and 1.051 per 1000 catheter-day for the chlorhexidine and the iodine cohorts, respectively. The use of chlorhexidine can significantly delay the time to first Gram-positive-cocci (GPC) PABSI (hazard ratio (HR) 0.41, 95% CI 0.20-0.84, p = 0.015). Other Independent predictors of increased GPC PABSI occurrence included previous chemotherapy (HR = 13.65, 95% CI = 4.12-45.26), total parental nutrition (HR =5.17, 95% CI = 2.51-10.63), chronic steroid use (HR = 7.02, 95% CI = 2.60-18.90), and postoperative antibiotics (HR = 2.06, 95% CI = 1.02-4.14). Chlorhexidine had no significant effects on preventing Gram-negative bacilli or fungal PABSI.Conclusion
The use of chlorhexidine as topical anti-septic may help prevent GPC-related PABSI in cancer patients.
(supported by grants NTUH 100-S1805)
|Enrollment||Oct 2009-Aug 2010||Dec 2010-Nov 2011|
|H&N cancer + NPC||20||26|
|N of stage IV||324 (0.82)||376 (0.77)||0.136|
All authors have declared no conflicts of interest.