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Central venous catheter-related infections in hematology and oncology

Guidelines of the Infectious Diseases Working Party (AGIHO) of the German Society of Hematology and Oncology (DGHO)

  • Review Article
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Abstract

Catheter-related infections (CRI) cause considerable morbidity in hospitalized patients. The incidence does not seem to be higher in neutropenic patients than in nonneutropenic patients. Gram-positive bacteria (coagulase-negative staphylococci, Staphylococcus aureus) are the pathogens most frequently cultured, followed by Candida species. Positive blood cultures are the cornerstone in the diagnosis of CRIs, while local signs of infection are not necessarily present. Blood cultures should be taken from peripheral blood and from the venous catheter. A shorter time to positivity of catheter blood cultures as compared with peripheral blood cultures supports the diagnosis of a CRI. In many cases, a definite diagnosis requires catheter removal and microbiological analysis. The role plate method with semiquantitative cultures has been established as standard in most laboratories. Antimicrobial treatment of CRI should be directed by the in vitro susceptibility of the isolated pathogen. Primary removal of the catheter is mandatory in S. aureus and Candida infections, as well as in case of tunnel or pocket infections. Future studies will elucidate whether the rate of CRI in neutropenic patients may be reduced by catheters impregnated with antimicrobial agents.

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Authors and Affiliations

  1. Klinik für Innere Medizin IV, Onkologie, Hämatologie und Hämostaseologie, Martin-Luther-Universität Halle, Ernst-Grube-Str. 40, 06120, Halle, Germany

    Hans-Heinrich Wolf

  2. Abteilung für Hämatologie und Onkologie, Klinik für Innere Medizin, Universität Rostock, Rostock, Germany

    Malte Leithäuser

  3. Medizinische Klinik, Hämatologie/Onkologie, Klinikum Ernst-von-Bergmann, Potsdam, Germany

    Georg Maschmeyer

  4. Abt. Hämatologie und Internistische Onkologie, Asklepios Klinik Hamburg Altona, Hamburg, Germany

    Hans Salwender

  5. Klinik für Innere Medizin V, Hämatologie, Onkologie und Rheumatologie, Ruprecht-Karls-Universität Heidelberg, Heidelberg, Germany

    Ulrike Klein & Gerlinde Egerer

  6. Medizinische Mikrobiologie und Krankenhausepidemiologie, Medizinische Hochschule Hannover, Hannover, Germany

    Iris Chaberny

  7. Department of Hematology, Oncology, Palliative Care, Evangelisches Krankenhaus, Bielefeld, Germany

    Florian Weissinger

  8. Universitätsklinikum Heidelberg-Mannheim, III. Medizinische Klinik, Mannheim, Germany

    Dieter Buchheidt

  9. Medizinische Klinik mit Schwerpunkt Hämatologie und Onkologie, Charité Campus Virchow-Klinikum Mitte, Berlin, Germany

    Markus Ruhnke

  10. Klinik I für Innere Medizin, Klinikum der Universität zu Köln, Cologne, Germany

    Oliver Cornely & Gerd Fätkenheuer

  11. Medizinische Klinik III, Johann-Wolfgang-Goethe-Universität, Frankfurt/M, Germany

    Sabine Mousset

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  1. Hans-Heinrich Wolf
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Correspondence to Hans-Heinrich Wolf.

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Wolf, HH., Leithäuser, M., Maschmeyer, G. et al. Central venous catheter-related infections in hematology and oncology. Ann Hematol 87, 863–876 (2008). https://doi.org/10.1007/s00277-008-0509-5

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