Hickman catheter site infections after allogeneic stem cell transplantation: a single-center experience

• Published in: Transplantation proceedings 2004-06, Vol.36 (5), p.1569-1573
• Main Authors: Kim, D.H, Bae, N.Y, Sung, W.J, Kim, J.G, Kim, S.W, Baek, J.H, Chang, H.H, Sohn, S.K, Lee, K.B
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Biological and medical sciences; Bone Marrow Transplantation - adverse effects; Bone Marrow Transplantation - methods; Catheterization, Central Venous - adverse effects; Female; Fundamental and applied biological sciences. Psychology; Fundamental immunology; Humans; Infection - epidemiology; Leukemia - therapy; Lymphoma - therapy; Male; Medical sciences; Middle Aged; Multiple Myeloma - therapy; Myelodysplastic Syndromes - therapy; Retrospective Studies; Stem Cell Transplantation - adverse effects; Stem Cell Transplantation - methods; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Tissue, organ and graft immunology; Transplantation, Homologous - adverse effects; Transplantation, Homologous - methods
• ISSN: 0041-1345; 1873-2623
• DOI: 10.1016/j.transproceed.2004.06.002

Hickman catheter site infections are known to increase transplant-related mortality. A retrospective analysis of 103 patients who received allogeneic stems cell transplants was performed to define the incidence and outcomes of Hickman infections. Seventy-six patients received peripheral blood stem cells (PBSC) (73.8%) and 29 patients (28.2%) nonmyeloablative conditioning. During the median follow-up of 9 months, Hickman infections were observed in 10 patients (9.7%) at a median onset of 32 days posttransplant (range 2 to 102 days). The causative organisms identified in five cases included Staphylococcus species ( n = 4) and Pseudomonas aeruginosa ( n = 1). Six events successfully resolved with antibiotic treatment, while the other four required the removal of the Hickman catheter with subsequent death in two cases. The survival duration for infected patients was shorter than that for the noninfected group (83 days vs 366 days, P < .001). Myeloid engraftment was delayed in the infected group (18.0 days vs 15.0 days, P = .038) and this complication was more frequently observed among the BMT compared with PBSC group (22.2% vs 5.3%, P = .019). Hickman infections were associated with transplant-related mortality especially during the first 3 months posttransplant. As such, the current results emphasize both the importance of Hickman catheter care and the need for surveillance cultures after stem cell transplantation.