Shim Jisue, Seo Tae-Seok, Song Myung Gyu, Cha In-Ho, Kim Jun Suk, Choi Chul Won, Seo Jae Hong, Oh Sang Cheul
Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine, Seoul 152-703, Korea.
Department of Oncology and Hematology, Korea University Guro Hospital, Korea University College of Medicine, Seoul 152-703, Korea.
Korean J Radiol. 2014 Jul-Aug;15(4):494-500. doi: 10.3348/kjr.2014.15.4.494. Epub 2014 Jul 9.
The purpose of this study was to determine the incidence and risk factors of infections associated with implantable venous access ports (IVAPs).
From August 2003 through November 2011, 1747 IVAPs were placed in our interventional radiology suite. One hundred forty four IVAPs were inserted in patients with hematologic malignancy and 1603 IVAPs in patients with solid tumors. Among them, 40 ports (23 women and 17 men; mean age, 57.1 years; range, 13-83) were removed to treat port-related infections. We evaluated the incidence of port-related infection, patient characteristics, bacteriologic data, and patient progress. Univariable analyses (t test, chi-square test, and Fisher's exact test) and multiple logistic regression analyses were used to determine the risk factors for IVAP related infection.
Overall, 40 (2.3%) of 1747 ports were removed for symptoms of infection with an incidence rate of 0.067 events/1000 catheter-days. According to the univariable study, the incidences of infection were seemingly higher in the patients who received the procedure during inpatient treatment (p = 0.016), the patients with hematologic malignancy (p = 0.041), and the patients receiving palliative chemotherapy (p = 0.022). From the multiple binary logistic regression, the adjusted odds ratios of infection in patients with hematologic malignancies and those receiving palliative chemotherapy were 7.769 (p = 0.001) and 4.863 (p = 0.003), respectively. Microorganisms were isolated from 26 (65%) blood samples, and two of the most causative organisms were found to be Staphylococcus (n = 10) and Candida species (n = 7).
The underlying hematologic malignancy and the state of receiving palliative chemotherapy were the independent risk factors of IVAP-related infection.
本研究旨在确定与植入式静脉输液港(IVAPs)相关感染的发生率及危险因素。
2003年8月至2011年11月期间,1747个IVAPs被植入我们的介入放射科手术室。144个IVAPs被植入血液系统恶性肿瘤患者体内,1603个IVAPs被植入实体瘤患者体内。其中,40个输液港(23名女性和17名男性;平均年龄57.1岁;范围13 - 83岁)因与输液港相关的感染而被移除。我们评估了与输液港相关感染的发生率、患者特征、细菌学数据及患者病情进展。采用单因素分析(t检验、卡方检验和Fisher精确检验)和多因素逻辑回归分析来确定IVAP相关感染的危险因素。
总体而言,1747个输液港中有40个(2.3%)因感染症状被移除,发生率为0.067次事件/1000导管日。根据单因素研究,住院治疗期间接受该操作的患者(p = 0.016)、血液系统恶性肿瘤患者(p = 0.041)以及接受姑息化疗的患者(p = 0.022)感染发生率似乎更高。多因素二元逻辑回归分析显示,血液系统恶性肿瘤患者和接受姑息化疗患者感染的校正比值比分别为7.769(p = 0.001)和4.863(p = 0.003)。从26份(65%)血样中分离出微生物,其中两种最常见的病原体为葡萄球菌(n = 10)和念珠菌属(n = 7)。
潜在的血液系统恶性肿瘤和接受姑息化疗的状态是IVAP相关感染的独立危险因素。