Prediction of central venous catheter–related bloodstream infections (CRBSIs) in patients with haematologic malignancies using a modified Infection Probability Score (mIPS)

详细信息    查看全文

• 作者：Enrico Schalk ; Lynn Hanus ; Jacqueline F?rber ; Thomas Fischer…
• 关键词：Central venous catheter ; Bloodstream infection ; Probability ; IPS ; Haematologic malignancies
• 刊名：Annals of Hematology
• 出版年：2015
• 出版时间：September 2015
• 年：2015
• 卷：94
• 期：9
• 页码：1451-1456
• 全文大小：148 KB
• 参考文献：1.Dettenkofer M, Ebner W, Bertz H, Babikir R, Finke J, Frank U, Rüden H, Daschner FD (2003) Surveillance of nosocomial infections in adult recipients of allogeneic and autologous bone marrow and peripheral blood stem-cell transplantation. Bone Marrow Transplant 31:795-01PubMed View Article
  2.Wisplinghoff H, Seifert H, Wenzel RP, Edmond MB (2003) Current trends in the epidemiology of nosocomial bloodstream infections in patients with hematological malignancies and solid neoplasms in hospitals in the United States. Clin Infect Dis 36:1103-110PubMed View Article
  3.Boersma RS, Jie KS, Verbon A, van Pampus EC, Schouten HC (2008) Thrombotic and infectious complications of central venous catheters in patients with hematological malignancies. Ann Oncol 19:433-42PubMed View Article
  4.Ziegler MJ, Pellegrini DC, Safdar N (2015) Attributable mortality of central line associated bloodstream infection: systematic review and meta-analysis. Infection 43:29-6PubMed View Article
  5.O’Grady NP, Alexander M, Burns LA, Dellinger EP, Garland J, Heard SO, Lipsett PA, Masur H, Mermel LA, Pearson ML, Raad II, Randolph AG, Rupp ME, Saint S, Healthcare Infection Control Practices Advisory Committee (HICPAC) (2011) Guidelines for the prevention of intravascular catheter-related infections. Clin Infect Dis 52:e162–e193PubMed Central PubMed View Article
  6.Hentrich M, Schalk E, Schmidt-Hieber M, Chaberny I, Mousset S, Buchheidt D, Ruhnke M, Penack O, Salwender H, Wolf HH, Christopeit M, Neumann S, Maschmeyer G, Karthaus M, Infectious Diseases Working Party of the German Society of Hematology and Medical Oncology (2014) Central venous catheter-related infections in hematology and oncology: 2012 updated guidelines on diagnosis, management and prevention by the Infectious Diseases Working Party of the German Society of Hematology and Medical Oncology. Ann Oncol 25:936-47PubMed View Article
  7.Peres Bota D, Mélot C, Lopes Ferreira F, Vincent JL (2003) Infection Probability Score (IPS): A method to help assess the probability of infection in critically ill patients. Crit Care Med 31:2579-584PubMed View Article
  8.Vincent JL, Moreno R, Takala J, Willatts S, De Mendon?a A, Bruining H, Reinhart CK, Suter PM, Thijs LG (1996) The SOFA (Sepsis-related Organ Failure Assessment) score to describe organ dysfunction/failure. On behalf of the Working Group on Sepsis-Related Problems of the European Society of Intensive Care Medicine. Intensive Care Med 22:707-10PubMed View Article
  9.Seifert H, Abele-Horn M, F?tkenheuer G, Glück T, Jansen B, Kern WV, Mack D, Plum G, Reinert RR, Roos R, Salzberger B, Shah PM, Ullmann U, Wei? M, Welte T, Wisplinghoff H, Mikrobiologisch-infektiologische Qualit?tsstandards (MiQ) (2007) Blutkulturdiagnostik -Sepsis, Endokarditis, Katheterinfektionen, Teil 1. Urban & Fischer, Munich
  10.Link H, B?hme A, Cornely OA, H?ffken K, Kellner O, Kern WV, Mahlberg R, Maschmeyer G, Nowrousian MR, Ostermann H, Ruhnke M, Sezer O, Schiel X, Wilhelm M, Auner HW, Diseases Working Party (AGIHO) of the German Society of Hematology and Oncology (DGHO); Group Interventional Therapy of Unexplained Fever, Arbeitsgemeinschaft Supportivmassnahmen in der Onkologie (ASO) of the Deutsche Krebsgesellschaft (DKG-German Cancer Society) (2003) Antimicrobial therapy of unexplained fever in neutropenic patients--guidelines of the Infectious Diseases Working Party (AGIHO) of the German Society of Hematology and Oncology (DGHO), Study Group Interventional Therapy of Unexplained Fever, Arbeitsgemeinschaft Supportivmassnahmen in der Onkologie (ASO) of the Deutsche Krebsgesellschaft (DKG-German Cancer Society). Ann Hematol 82(Suppl 2):S105–S117PubMed View Article
  11.Cohen J (1988) Statistical power analysis for the behavioral sciences, 2nd edn. Lawrence Erlbaum, Hillsdale
  12.Swets JA (1988) Measuring the accuracy of diagnostic systems. Science 240:1285-293PubMed View Article
  13.Martini A, Gottin L, Mélot C, Vincent JL (2008) A prospective evaluation of the Infection Probability Score (IPS) in the intensive care unit. J Infect 56:313-18PubMed View Article
  14.Apostolopolou E, Raftopoulos V, Terzis K, Pissaki K, Pagoni M, Delibasi S (2010) Infection probability score, APACHE II and KARNOFSKY scoring systems as predictors of infection onset in haematology-oncology patients. J Clin Nurs 19:1560-568PubMed View Article
  15.Apostolopoulou E, Raftopoulos V, Terzis K, Elefsiniotis I (2010) Infection Probability Score, APACHE II and KARNOFSKY scoring systems as predictors of bloodstream infection onset in hematology-oncology patients. BMC Infect Dis 10:135PubMed Central PubMed View Article
  16.Apostolopoulou E, Raftopoulos V, Terzis K, Elefsiniotis I (2011) Infection Probability Score: a predictor of Clostridium difficile-associated disease onset in patients with haematological malignancy. Eur J Oncol Nurs 15:404-09PubMed View Article
  17.Ratzinger F, Schuardt M, Eichbichler K, Tsirkinidou I, Bauer M, Haslach
• 作者单位：Enrico Schalk (1)
  Lynn Hanus (1)
  Jacqueline F?rber (2)
  Thomas Fischer (1)
  Florian H. Heidel (1)
  
  1. Department of Haematology and Oncology, Medical Centre, Otto-von-Guericke University Magdeburg, Leipziger Str. 44, 39120, Magdeburg, Germany
  2. Department of Medical Microbiology, Infection Control and Prevention, Medical Centre, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
  
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Hematology
  Oncology
  
• 出版者：Springer Berlin / Heidelberg
• ISSN：1432-0584

文摘

The aim of this study was to predict the probability of central venous catheter–related bloodstream infections (CRBSIs) in patients with haematologic malignancies using a modified version of the Infection Probability Score (mIPS). In order to perform a prospective, mono-centric surveillance of complications in clinical routine due to short-term central venous catheters (CVCs) in consecutive patients receiving chemotherapy from March 2013 to September 2014, IPS was calculated at CVC insertion and removal (mIPSin and mIPSex, respectively). We used the 2012 Infectious Diseases Working Party of the German Society of Haematology and Medical Oncology (AGIHO/DGHO) criteria to define CRBSI. In total, 143 patients (mean 59.5?years, 61.4?% male) with 267 triple-lumen CVCs (4044 CVC days; mean 15.1?days, range 1-0?days) were analysed. CVCs were inserted for therapy of acute leukaemia (53.2?%), multiple myeloma (24.3?%) or lymphoma (11.2?%), and 93.6?% were inserted in the jugular vein. A total of 66 CRBSI cases (24.7?%) were documented (12 definite/13 probable/41 possible). The incidence was 16.3/1000 CVC days (2.9/3.1/10.1 per 1000 CVC days for definite/probable/possible CRBSI, respectively). In CRBSI cases, the mIPSex was higher as compared to cases without CRBSI (13.1 vs. 7.1; p-lt;-.001). The best mIPSex cutoff for CRBSI prediction was 8 points (area under the curve (AUC)--.77; sensitivity = 84.9?%, specificity = 60.7?%, negative predictive value = 92.4?%). For patients with an mIPSex ?, the risk for a CRBSI was high (odds ratio [OR]--.9; p-lt;-.001) and even increased if, additionally, CVC had been in use for about 10?days (OR--.8; p-lt;-.001). In case other causes of infection are excluded, a mIPSex ? and duration of CVC use of about 10?days predict a very high risk of CRBSI. Patients with a mIPSex <8 have a low risk of CRBSI of 8?%.