In patients with cancer, prognostic factors of catheter-related thrombosis (CRT) are different than prognostic factors of VTE. A prospective cohort study in 3032 cancer patients with central venous catheter (ONCOCIP)

2018 ◽  
Vol 164 ◽  
pp. S216-S217
Author(s):  
H. Decousus ◽  
L. Bertoletti ◽  
P. Fournel ◽  
A. Bourmaud ◽  
C. Labruyère ◽  
...  
Keyword(s):  
Cohort Study ◽  
Prognostic Factors ◽  
Central Venous Catheter ◽  
Cancer Patients ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Venous Catheter ◽  
Central Venous ◽  
Patients With Cancer ◽  
Catheter Related Thrombosis

scholarly journals Frequency and Characteristics of Infections Caused by Extended-Spectrum Beta-Lactamase-Producing Organisms in Neonates: A Prospective Cohort Study

2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
Nandini Vijayakanthi ◽  
Dheeraj Bahl ◽  
Nirmaljit Kaur ◽  
Arti Maria ◽  
Nand Kishore Dubey
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Central Venous Catheter ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Venous Catheter ◽  
Beta Lactamase ◽  
Central Venous ◽  
Extended Spectrum Beta Lactamase ◽  
Extended Spectrum

This prospective cohort study was conducted to determine the frequency of infections caused by extended-spectrum beta-lactamase- (ESBL-) producing organisms, various bacteria producing ESBL, antibiotic susceptibility of these organisms, and the risk factors associated with these infections in a neonatal intensive care unit in a tertiary care hospital in North India. Of the 150 neonates enrolled in the study, 47 culture-positive neonates were included in the study cohort and were divided into two groups: ESBL-positive (8 neonates) and ESBL-negative (39 neonates) cohorts. Various organisms were isolated from 72 culture samples in these 47 neonates. Of these, 10 culture samples grew ESBL-positive organisms and 62 samples grew ESBL-negative organisms. The frequency of ESBL-producing organisms was found to be 5.3%. ESBL infection incidence densities were found to be 3.4 per 1000 patient-days.Klebsiella(60%) was the most common organism producing ESBL followed byEscherichia coli(30%) andPseudomonas(10%). Eighty percent of the ESBL-producing organisms were sensitive to piperacillin-tazobactam. Risk factors found significant by univariate analysis (P<0.05) were preterm, low birthweight, perinatal asphyxia, respiratory distress syndrome, anaemia, metabolic acidosis, prolonged mechanical ventilation (>7 days), length of hospitalization, length of level 3 stay, prior antibiotic use, central venous catheter duration, peripherally inserted central venous catheter duration, and total parenteral nutrition duration. Factors that retained significance in the logistic regression model were duration of hospital stay (adjusted OR: 0.958, CI: 0.920–0.997, andPvalue = 0.037) and gestational age (adjusted OR: 1.39, CI: 1.037–1.865, andPvalue = 0.028). There was no significant difference in the mortality between the two groups.

Long-Term Central Venous Catheter Infection in HIV-infected and Cancer Patients: A Multicenter Cohort Study

1999 ◽  
Vol 20 (7) ◽  
pp. 494-498 ◽  
Author(s):  
Pascal Astagneau ◽  
Sylvie Maugat ◽  
Tuan Tran-Minh ◽  
Marie-Cécile Douard ◽  
Pascale Longuet ◽  
...  
Keyword(s):  
Cohort Study ◽  
Central Venous Catheter ◽  
Cancer Patients ◽  
Venous Catheter ◽  
Central Venous ◽  
Hiv Patients ◽  
Multicenter Cohort Study ◽  
Multicenter Cohort ◽  
Hiv And Cancer

Objectives:To evaluate and compare the risk of long-term central venous catheter (CVC) infection in human immunodeficiency virus (HIV)-infected and cancer patients.Design:Prospective multicenter cohort study based on active surveillance of long-term CVC manipulations and patient outcome over a 6-month period.Setting:Services of infectious diseases and oncology of 12 university hospitals in Paris, France.Participants:In 1995, all HIV and cancer patients with solid malignancy were included at the time of long-term CVC implantation.Results:Overall, 31.6% of long-term CVC infections were identified in 32% of 201 HIV and 5% of 255 cancer patients. Most were associated with bacteremia, most commonly coagulase-negative staphylococci. The long-term CVC time-related infection risk was greater in HIV than in cancer patients (3.78 vs 0.39 infections per 1,000 long-term CVC days; P<.001). The independent risk factors of long-term CVC infection were as follows: in HIV patients, frequency of long-term CVC handling and neutropenia; in cancer patients, poor Karnofsky performance status; in both HIV and cancer patients, recent history of bacterial infection. The risk of long-term CVC infection was similar for tunneled catheters and venous access ports in each population.Conclusions:Prevention of long-term CVC infection should focus first on better sterile precautions while handling long-term CVC, especially in HIV patients who have frequent and daily use of the long-term CVC.

scholarly journals Early prophylaxis of central venous catheter-related thrombosis using 1% chlorhexidine gluconate and chlorhexidine-gel-impregnated dressings: a retrospective cohort study

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Tomoko Yamashita ◽  
Ayako Takamori ◽  
Akira Nakagawachi ◽  
Yoshinori Tanigawa ◽  
Yohei Hamada ◽  
...  
Keyword(s):  
Cohort Study ◽  
Central Venous Catheter ◽  
Retrospective Cohort Study ◽  
Critically Ill Patients ◽  
Retrospective Cohort ◽  
Venous Catheter ◽  
Chlorhexidine Gluconate ◽  
Central Venous ◽  
Chlorhexidine Gel ◽  
Catheter Related Thrombosis

Abstract To determine the prophylactic effect of using combined 1% alcoholic chlorhexidine gluconate and chlorhexidine gel-impregnated dressings (CGCD) on catheter-related thrombosis (CRT) in critically ill patients. This retrospective cohort study was performed in an intensive care unit from November 2009 to August 2014. The CRT incidence diagnosed with ultrasound examination was compared between patients applying CGCD and combined 10% aqueous povidone-iodine and standard transparent dressings (PITD) after central venous catheter insertion into the internal jugular vein for ≥ 48 h. CRT was stratified into early (within 7 days) and late (days 8–14) thromboses. Multivariate analyses using logistic regression models clarified the relationships between early- and late-CRT risks and skin antiseptic and catheter site dressing combinations. CRT occurred in 74 of 134 patients (55%), including 52 with early CRT and 22 with late CRT. Patients receiving CGCD had a significantly lower incidence of early CRT than those receiving PITD (odds ratio = 0.18; 95% confidence interval = 0.07–0.45, p  < .001). No significant association was evident between using CGCD and late CRT (p  = .514). Compared to PITD, CGCD reduced the CRT risk over 7 days in critically ill patients. UMIN Clinical Trials Registry: UMIN000037492.

scholarly journals Large Cohort Study of Central Venous Catheter Thrombosis during Intravenous Antibiotic Therapy

2015 ◽  
Vol 60 (1) ◽  
pp. 36-43 ◽  
Author(s):  
Stéphanie Guillet ◽  
Valérie Zeller ◽  
Vincent Dubée ◽  
Françoise Ducroquet ◽  
Nicole Desplaces ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Central Venous Catheter ◽  
Antibiotic Therapy ◽  
Antimicrobial Therapy ◽  
Anticoagulation Therapy ◽  
Venous Catheter ◽  
Central Venous ◽  
Catheter Malposition ◽  
Catheter Related Thrombosis

ABSTRACTThe frequency and risk factors for central venous catheter-related thrombosis (CRT) during prolonged intravenous (i.v.) antibiotic therapy have rarely been reported. The primary objective of this study was to evaluate the frequency, incidence, and risk factors for CRT among patients being treated with prolonged i.v. antibiotic therapy. The secondary objective was to describe the clinical manifestations, diagnostic evaluation, and clinical management. This cohort study was conducted between August 2004 and May 2010 in a French referral center for osteoarticular infections. All patients treated for bone and joint infections with i.v. antimicrobial therapy through a central venous catheter (CVC) for ≥2 weeks were included. Risk factors were identified using nonparametric tests and logistic regression. A case-control study investigated the role of vancomycin and catheter malposition. A total of 892 patients matched the inclusion criteria. CRT developed in 16 infections occurring in 16 patients (incidence, 0.39/1,000 catheter days). The median time to a CRT was 29 days (range, 12 to 48 days). Local clinical signs, fever, and secondary complications of CRT were present in 15, 8, and 4 patients, respectively. The median C-reactive protein level was 95 mg/liter. The treatment combined catheter removal and a median of 3 months (1.5 to 6 months) of anticoagulation therapy. The outcome was good in all patients, with no recurrence of CRT. Three risk factors were identified by multivariate analysis: male sex (odds ratio [OR], 5.4; 95% confidence interval [CI], 1.1 to 26.6), catheter malposition (OR, 5.3; 95% CI, 1.6 to 17.9), and use of vancomycin (OR, 22.9; 95% CI, 2.8 to 188). Catheter-related thrombosis is a rare but severe complication in patients treated with prolonged antimicrobial therapy. Vancomycin use was the most important risk factor identified.

D-dimer from central and peripheral blood samples in asymptomatic central venous catheter-related thrombosis in patients with cancer

2018 ◽  
Vol 34 (1) ◽  
pp. 52-57 ◽  
Author(s):  
Homero Nañez-Terreros ◽  
Jose C Jaime-Perez ◽  
Linda E Muñoz-Espinoza ◽  
Carlos R Camara-Lemaroy ◽  
Gerardo E Ornelas-Cortinas ◽  
...  
Keyword(s):  
Central Venous Catheter ◽  
Venous Blood ◽  
Venous Catheter ◽  
Central Venous ◽  
False Negatives ◽  
Altman Plot ◽  
Patients With Cancer ◽  
Peripheral Samples ◽  
Catheter Related Thrombosis ◽  
D Dimer

Objectives To evaluate the usefulness of a negative D-dimer in peripheral or central venous blood to screen for asymptomatic catheter-related thrombosis in cancer patients. Methods D-dimer was measured in blood from central venous catheter and peripheral venous samples in 48 patients with cancer. Asymptomatic catheter-related thrombosis was identified via Doppler ultrasound. Bland and Altman’s limits of agreement analysis was used to compare sample sites. Sensitivity and specificity of D-dimer was calculated. Results Overall, 33 of the central samples and 32 of the peripheral samples had D-dimer levels below the cutoff (≥0.3 mg/l). Mean central D-dimer was 0.31 ± 0.35 mg/l; peripheral 0.24 ± 0.22 mg/l (p = 0.5). Bland–Altman plot showed that the two sample sites were not equivalent. Catheter-related thrombosis was demonstrated in five patients, and there were three false negatives. Peripheral D-dimer had a negative predictive value of 90.9%. Conclusions A negative D-dimer may be useful for screening asymptomatic catheter-related thrombosis in patients with cancer, but the central and peripheral sample sites are not equivalent.

scholarly journals Responses to SARS-CoV-2 Vaccination in Patients with Cancer (ReCOVer Study): A Prospective Cohort Study of the Hellenic Cooperative Oncology Group

Cancers ◽  
2021 ◽  
Vol 13 (18) ◽  
pp. 4621
Author(s):  
Helena Linardou ◽  
Nikolaos Spanakis ◽  
Georgia-Angeliki Koliou ◽  
Athina Christopoulou ◽  
Sofia Karageorgopoulou ◽  
...  
Keyword(s):  
Cohort Study ◽  
Cancer Patients ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Seropositivity Rate ◽  
Humoral Immune ◽  
Patients With Cancer ◽  
Observational Prospective Cohort Study ◽  
Antibody Titers ◽  
Never Smokers

Data on the effectiveness and safety of approved SARS-CoV-2 vaccines in cancer patients are limited. This observational, prospective cohort study investigated the humoral immune response to SARS-CoV-2 vaccination in 232 cancer patients from 12 HeCOG-affiliated oncology departments compared to 100 healthcare volunteers without known active cancer. The seropositivity rate was measured 2–4 weeks after two vaccine doses, by evaluating neutralising antibodies against the SARS-CoV-2 spike protein using a commercially available immunoassay. Seropositivity was defined as ≥33.8 Binding-Antibody-Units (BAU)/mL. A total of 189 patients and 99 controls were eligible for this analysis. Among patients, 171 (90.5%) were seropositive after two vaccine doses, compared to 98% of controls (p = 0.015). Most seronegative patients were males (66.7%), >70-years-old (55.5%), with comorbidities (61.1%), and on active treatment (88.9%). The median antibody titers among patients were significantly lower than those of the controls (523 vs. 2050 BAU/mL; p < 0.001). The rate of protective titers was 54.5% in patients vs. 97% in controls (p < 0.001). Seropositivity rates and IgG titers in controls did not differ for any studied factor. In cancer patients, higher antibody titers were observed in never-smokers (p = 0.006), women (p = 0.022), <50-year-olds (p = 0.004), PS 0 (p = 0.029), and in breast or ovarian vs. other cancers. Adverse events were comparable to registration trials. In this cohort study, although the seropositivity rate after two vaccine doses in cancer patients seemed satisfactory, their antibody titers were significantly lower than in controls. Monitoring of responses and further elucidation of the clinical factors that affect immunity could guide adaptations of vaccine strategies for vulnerable subgroups.

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