Central venous catheter-related bloodstream infections in cancer patients.

OBJECTIVE To determine the frequency of central venous catheter-related bloodstream infections (CR-BSI) in cancer patients and the antimicrobial susceptibility pattern of the isolates. DESIGN A cross-sectional study. PLACE AND DURATION OF STUDY The study was conducted between April 2002 and March 2003 at the Armed Forces Institute of Pathology, Rawalpindi in collaboration with Oncology Units of Armed Forces Bone Marrow Transplant Centre and Combined Military Hospital, Rawalpindi. SUBJECTS AND METHODS Cancer patients requiring short or long-term central venous catheterization at the time of admission or thereafter were included. Catheter tips on removal were cultured quantitatively; specimens of blood and pus were cultured qualitatively. Isolates were identified and antimicrobial susceptibility testing was performed by standard techniques. RESULTS Eighty-nine patients were included in the study. The frequency of CR-BSI was 17%. Out of the 19 organisms isolated, 10 (53%) were Gram-positive cocci, 8 (42%) were Gram-negative rods and 1 (5%) was a fungus. Coagulase negative staphylococci (27%) were the predominant pathogens. Among the staphylococci, 46% of the isolates were methicillin-resistant. All Gram-positive isolates were susceptible to glycopeptides. Gram-negative rods were resistant to most of the commonly used antimicrobial groups. CONCLUSION Central venous catheter is an important source of bloodstream infections in cancer patients. Most of the infections are caused by Gram-positive cocci. Rigorous infection control measures and continuous surveillance are required to curb the frequency of these infections.