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

Autor: Simon Rolland, Najiby Kassis-Chikhani, Edouard Auclin, Samuel Bensaid, Anne-Laure Bidaud, Marie-Paule Gerlinger, Damien Blez, Jean-Luc Mainardi, David Lebeaux, Marie Dubert
Rok vydání: 2022
Předmět:
Zdroj: European Journal of Clinical Microbiology & Infectious Diseases. 42:161-168
ISSN: 1435-4373
0934-9723
DOI: 10.1007/s10096-022-04537-x
Popis: 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.
Databáze: OpenAIRE
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