Casado J L, Navas E, Garcia A, Antela A, Redondo E, Fortun J, Guerrero A
Department of Microbiology, Hospital Ramón y Cajal, Madrid, Spain.
QJM. 1996 Sep;89(9):695-9. doi: 10.1093/qjmed/89.9.695.
We studied the infection rate of long-term intravenous access used for daily home treatment of cytomegalovirus (CMV) disease in 61 AIDS patients who had 75 central venous catheters implanted for antiviral maintenance therapy between February 1989 and December 1994. In 39 patients (64%) the risk factor for AIDS was intravenous drug abuse. Sixty-three catheters were Hickman type and 12 were totally implanted ports. The cumulative follow-up time was 19000 catheter-days (52 patient-years), with median duration of placement of 249 days. The infection rate was 0.22 infections per 100 catheter days. The probability of remaining free of catheter-related sepsis was 58% at 6 months. In 25 cases (61%) antimicrobial therapy without catheter removal was successful. Three patients died because of a catheter-related infection (mortality rate 7.3%). Infection-free survival time was not related to the risk factor for AIDS (p = 0.44) or type of device (p = 0.41). The total infection rate in these patients receiving daily home maintenance therapy for CMV disease through a long-term catheter was similar to that in other AIDS patients receiving weekly treatment in hospital facilities.
我们研究了61例艾滋病患者长期静脉通路的感染率，这些患者在1989年2月至1994年12月期间植入了75根中心静脉导管用于抗巨细胞病毒（CMV）疾病的居家日常治疗。39例（64%）患者的艾滋病危险因素为静脉注射毒品。63根导管为希克曼型，12根为完全植入式端口。累计随访时间为19000导管日（52患者年），导管留置的中位时长为249天。感染率为每100导管日0.22例感染。6个月时无导管相关败血症的概率为58%。25例（61%）未拔除导管的抗菌治疗成功。3例患者因导管相关感染死亡（死亡率7.3%）。无感染生存时间与艾滋病危险因素（p = 0.44）或装置类型（p = 0.41）无关。这些通过长期导管接受CMV疾病居家维持治疗的患者的总感染率与其他在医院设施接受每周治疗的艾滋病患者相似。
