Sex-Disaggregated Analysis of Central Venous Catheter-Related Bloodstream Infections in Patients with Cancer

被引：1

作者：

Schalk, Enrico ^{[1
]}

Seltmann, Alva ^{[2
]}

Boell, Boris ^{[3
]}

Giesen, Nicola ^{[4
]}

Grans-Siebel, Judit ^{[3
,6
]}

Kriege, Oliver ^{[5
]}

Lanznaster, Julia

Minti, Antrea ^{[7
,8
]}

Naendrup, Jan-Hendrik ^{[3
]}

Neitz, Julia ^{[9
]}

Panse, Jens ^{[7
,8
]}

Schmidt-Hieber, Martin ^{[10
]}

Seggewiss-Bernhardt, Ruth ^{[11
]}

Teschner, Daniel ^{[5
,12
]}

Weber, Philipp ^{[13
]}

Wille, Kai ^{[14
]}

von Lilienfeld-Toal, Marie

Hentrich, Marcus

机构：

[1] Otto von Guericke Univ, Med Fac, Dept Hematol Oncol & Cell Therapy, Magdeburg, Germany

[2] Ruhr Univ Bochum, Inst Divers Med, Bochum, Germany

[3] Univ Hosp Cologne, Dept Internal Med 1, Cologne, Germany

[4] Robert Bosch Krankenhaus Stuttgart, Dept Hematol Oncol & Palliat Med, Stuttgart, Germany

[5] Johannes Gutenberg Univ Mainz, Univ Med Ctr, Dept Hematol & Med Oncol, Mainz, Germany

[6] Passau Hosp, Dept Internal Med 2, Passau, Germany

[7] Univ Hosp RWTH Aachen, Dept Oncol Hematol Hemostaseol & Stem Cell Transpl, Aachen, Germany

[8] Ctr Integrated Oncol CIO, Dusseldorf ABCD, Aachen, Germany

[9] Red Cross Hosp Munich, Dept Hematol & Oncol, Munich, Germany

[10] Med Univ Lausitz Carl Thiem MUL CT, Clin Hematol Oncol Pneumol Nephrol & Diabetol, Cottbus, Germany

[11] Sozialstiftung Bamberg, Dept Hematol & Oncol, Bamberg, Germany

[12] Univ Hosp Wurzburg, Dept Internal Med 2, Wurzburg, Germany

[13] Klinikum Mutterhaus Borromaerinnen, Dept Internal Med, Trier, Germany

[14] Univ Bochum, Univ Clin Hematol Oncol Hemostaseol & Palliat Care, Minden, Germany

来源：

ONCOLOGY RESEARCH AND TREATMENT | 2024年

关键词：

Sex; Central venous catheter; Bloodstream infection; Cancer; SOLID TUMORS; INSERTION SITE; RISK-FACTORS; EPIDEMIOLOGY; COLONIZATION; HEMATOLOGY; DIAGNOSIS;

D O I：

10.1159/000542535

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Introduction: Men are generally more susceptible to bacterial infections than women. Central venous catheters (CVCs), often used to administer systemic treatment in patients with cancer, are an important source of infection. However, little is known about sex-specific differences of CVC-related bloodstream infections (CRBSIs) in patients with cancer. This study aimed to compare CRBSIs in men versus women in a large cohort of patients with cancer. Methods: Data were derived from the SECRECY registry including nonselected patients with centrally inserted non-tunneled internal jugular or subclavian vein CVCs in 10 hematology and oncology sites in Germany. Only CRBSIs classified as definite CRBSI (dCRBSI) or probable CRBSI were included, and the combination of both was summarized as dpCRBSI. CVCs were matched 1:1 for underlying disease, anatomic site of CVC insertion, type of CVC dressing, antimicrobial coated CVC, complicated CVC insertion, and CVC in situ time by propensity score matching (PSM). Endpoints were CRBSI rates and incidences in CVCs inserted in men versus women. Results: A total of 5,075 CVCs registered from March 2013 to March 2024 were included in the analysis, of which 3,024 comprise the PSM cohort. A total of 1,512 (50.0%) CVCs were inserted in men. Underlying diseases mainly were hematological malignancies (96.4%). While there was no statistically significant difference between men and women in the dCRBSI rate (5.4% vs. 4.1%; p = 0.12) and the dCRBSI incidence (3.8 vs. 2.9/1,000 CVC days; p = 0.11), the rate of dpCRBSI (9.9% vs. 6.7%; p = 0.002) and the dpCRBSI incidence (7.0 vs. 4.7/1,000 CVC days; p = 0.002) were significantly higher in men versus women. The proportion of coagulase-negative staphylococci as causative agent of both dCRBSI and dpCRBSI was higher in men than in women (58.8% vs. 41.2%; p = 0.07 and 61.5% vs. 38.5%; p = 0.002, respectively). A multivariable regression revealed neutropenia as an independent risk factor for dCRBSI and male sex as risk factor for dCRBSI and dpCRBSI. Conclusion: In patients with hematological malignancies, men have a higher risk of CRBSI than women. This finding may be attributed to the high number of jugular vein-inserted CVCs, which in men may be associated with higher rates of skin colonization than in women. Special preventive measures such as earlier removal of CVCs in men may be studied in future.

引用

页码：37 / 46

页数：10

共 45 条

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