Simoné G, Piroth L, Lakkis Z, Rat P, Heyd B, Ortega-Deballon P
Service de chirurgie viscérale et transplantation, CHU Jean-Minjoz, 25030 Besançon, France.
Service de maladies infectieuses, CHU du Bocage, 21000 Dijon, France.
Med Mal Infect. 2014 Jul;44(7):315-20. doi: 10.1016/j.medmal.2014.06.003. Epub 2014 Jul 10.
We had for objective to assess the risk of a new Port-a-Cath (PAC) infection after re-implantation when the first one had been removed because of infection in the previous month.
We conducted a retrospective bicentric study including all patients having undergone PAC removal because of infection, followed by re-implantation of a new one in the next month, between 2004 and 2012.
One hundred and forty-nine PAC removals were followed by re-implantation in the next month. The cause of removal was infection for 63 patients: 34 presented with bacteremia (13 PAC removals and simultaneous re-implantation, and 21 with delayed re-implantation for a mean 14days) and 29 presented with local signs of infection (20 PAC removals and simultaneous re-implantation, and with delayed re-implantation for a mean 13days). Two out of 13 PACs were re-infected in the bacteremia group, (15.4%) when the removal and re-implantation were performed simultaneously, and 1 out of 21 (4.8%) when re-implantation of the second PAC was delayed. The 3 re-infected PACs were successfully treated with antibiotics.
The early re-implantation of a PAC after removal of the previous one because of infection is a relatively safe procedure. The risk of infection can be higher when PAC removal and re-implantation are performed simultaneously in patients presenting with bacteremia; nevertheless, all reinfections were successfully treated with antibiotics.
我们旨在评估因前一个月感染而拔除的输液港(Port-a-Cath,PAC)重新植入后发生新感染的风险。
我们进行了一项回顾性双中心研究,纳入了2004年至2012年间所有因感染而拔除PAC,随后在下个月重新植入新PAC的患者。
149例PAC拔除后在下个月进行了重新植入。拔除原因是感染的患者有63例:34例出现菌血症(13例PAC拔除并同时重新植入,21例延迟重新植入,平均延迟14天),29例出现局部感染体征(20例PAC拔除并同时重新植入,9例延迟重新植入,平均延迟13天)。菌血症组中,13例同时进行拔除和重新植入的PAC中有2例(15.4%)再次感染,21例延迟重新植入第二个PAC的患者中有1例(4.8%)再次感染。3例再次感染的PAC均通过抗生素成功治疗。
因感染拔除PAC后早期重新植入是一种相对安全的操作。对于出现菌血症的患者,同时进行PAC拔除和重新植入时感染风险可能更高;尽管如此,所有再次感染均通过抗生素成功治疗。