Retrospective investigation of port catheter associated infections in childhood acute leukemia patients

Central venous catheters are devices that facilitate the delivery of chemotherapies, anti-biotherapies, blood products, fluid and parenteral nutrition supplements in children with hematological diseases. Port catheters are the most common central venous catheters used in patients with leukemia. With the widespread use of port catheters, catheter-related systemic and local infections have emerged as an important cause of morbidity. Retrospective investigation of catheter-related infections developed in patients with acute leukemia at Dicle University Children Hematology and Oncology clinic and who used port catheter as vascular access device; it was aimed to compare the collected data with patients who did not use a port catheter and other studies in this field, to determine the frequency and causes of bacteremia, which is an important complication caused by the port catheter, to help decide empirical antibiotic treatments for reproductive factors and to reduce the frequency of infections related to port catheters. Between January 2012 and August 2019, 165 patients, aged between 0 and 18 years old, who were diagnosed and treated in the Department of Pediatric Hematology and Oncology at the Department of Child Health and Diseases at Dicle University, were included. Demographic characteristics of patients such as age and gender; medical histories and clinical physical examination findings, hemogram, C-reactive protein, blood cultures, catheter and catheter tip cultures, culture antibiograms and anti-biotherapy used were investigated due to hospital records. Eighty-five patients with acute leukemia using port catheter as vascular access device were identified as the study group (Group-1), and 80 patients with acute leukemia (Group-2) who had never used a central vascular access device were designated as the control group. The total number of port catheter day was 61557 days. The average number of days spent with the port was 580.92 ± 368.48 days and the time of insertion of the port catheter after the first diagnosis was 22.73 ± 19.73 days after the first diagnosis. The number of attacks per 1000 days passed through the port catheter was determined as 2.45 attacks. The most frequent factors in Group-1 and Group-2 were coagulase negative staphylococci. There was a statistically significant difference in the frequency of infection attacks between Group-1 and Group-2, mean duration of fever response, use of the average colony stimulating factor (G-CSF) days. In the light of the results obtained from our study, we think that blood circulation infections, which are the most important complication of port use in childhood acute leukemia patients, can be treated effectively when appropriate antimicrobial treatment is given through guides. We believe that the duration of the use of port catheters does not increase the frequency of blood circulation infections and that port catheters can be used safely during the treatment of acute leukemia disease, if appropriate care conditions are provided for patients. In addition, we think that it is important to study the CRP value during the infection attack in patients using the port catheter, as it will provide information about the duration and severity of the infection attack.