TIVAP-related infection due to Gram-negative aerobic bacilli: should TIVAP stay or should it go?

Autor: Rolland, Simon, Kassis-Chikhani, Najiby, Auclin, Edouard, Bensaid, Samuel, Bidaud, Anne-Laure, Gerlinger, Marie-Paule, Blez, Damien, Mainardi, Jean-Luc, Lebeaux, David, Dubert, Marie
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Zdroj: European Journal of Clinical Microbiology & Infectious Diseases; Feb2023, Vol. 42 Issue 2, p161-168, 8p
Abstrakt: We aimed to describe the outcome of totally implantable venous-access port (TIVAP)-related infections due to Gram-negative aerobic bacilli (Pseudomonas aeruginosa and other Pseudomonas spp., Acinetobacter spp., and Stenotrophomonas maltophilia), or GNAB, and assess the safety of conservative treatment. We conducted a retrospective study in a French teaching hospital, from January 2016 to December 2020, including adult patients treated for TIVAP-related infection due to GNAB. Success of conservative treatment was defined as a functional TIVAP 3 months after infection with no recurrence. We performed a bivariate analysis and analyzed causes for treatment failure. We included 68 patients (53 TIVAP-related bloodstream infections, 11 TIVAP-related infections, and 4 probable TIVAP-related infections) due to GNAB, mostly P. aeruginosa (50/68, 74%). TIVAP removal was initially decided for 49/68 patients (72%). Among the 19/68 (28%) patients with conservative treatment (all for infections caused by P. aeruginosa), 5/19 (26%) had successful treatment, 7/19 (37%) experienced failure (without sepsis or septic shock), 6/19 (32%) died within 3 months without TIVAP removal and no signs of infection recurrence, and 1 patient had TIVAP removal as it was no longer required. TIVAP-related infections caused by GNAB frequently require TIVAP removal. Conservative treatment can be performed in selected patients with a non-complicated infection caused by P. aeruginosa, who can benefit from the continuation of antineoplastic chemotherapy or palliative care. Treatment failures were not associated with sepsis or septic shock. [ABSTRACT FROM AUTHOR]
Databáze: Complementary Index
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