REGULAR CONTENT
Final ID
553
Type
Original Scientific Research-Oral or Pos
Authors
M Groenwald1, I Latich1, T Friedman2, D Silin3
Institutions
1Yale University, New Haven, CT, 2Weill Cornell Medicine, New York, NY, 3N/A, Cheshire, CT
Purpose
Preoperative antibiotics are often given prior to port placement. There are conflicting data whether a single prophylactic dose prevents port site infection and systemic bacteremia within the first month following placement.
Materials & Methods
Single institution IRB approved retrospective review of adult patients presenting for port placement. Procedure date, MRN, antibiotic agent, number of lumens, indication, age, and gender were documented. Ports placed and removed within 30 days were investigated. If infection was indication for removal, the following was documented: site infection on removal, bacteremia, cultured agents, and source of culture (blood stream, port site, other). Incidence rates were calculated and compared between the antibiotic vs. no-antibiotic arms. Chi-squared analysis was used for comparison.
Results
5967 port placements were included, of which 61.4% were in women. The mean age of patients undergoing port placement was 59.3 years (SD+/- 14 years). 52% Of removed ports were from women (p=0.1741), at a mean age of 55.3 years. 67% (3978) received antibiotics while 33% (1989) did not.52 ports were removed within 30 days, 29% within the first two weeks and 71% within the last two weeks. 50 of these were due to infection concern, 35 in the antibiotic arm vs 15 in the no-antibiotic arm. Incidence of removal was 0.87% in the antibiotic arm vs 0.75% in the no-antibiotic arm (p= 0.629). There was evidence of site infection on removal in 0.301% of antibiotic arm cases vs 0.298% in the no-antibiotic arm (p=0.9840). 53.3% patients with ports removed from the no-antibiotic arm (8/15) had bacteremia with a skin agent compared with 48.5% (17/35) in the antibiotic arm (p=0.7581).Notably, 26% of removed ports were in patients with primary lymphoma or liquid dyscrasia, compared with 13% incidence of these in the total population (p=0.0067). Otherwise no association was seen between infection rates and placement indication.
Conclusions
Single dose of pre-procedural antibiotics does not prevent against immediate post-procedural local infection or associated skin agent bacteremia. The incidence of infection is higher in patients with lymphoma and/or liquid dyscrasias.
Final ID
553
Type
Original Scientific Research-Oral or Pos
Authors
M Groenwald1, I Latich1, T Friedman2, D Silin3
Institutions
1Yale University, New Haven, CT, 2Weill Cornell Medicine, New York, NY, 3N/A, Cheshire, CT
Purpose
Preoperative antibiotics are often given prior to port placement. There are conflicting data whether a single prophylactic dose prevents port site infection and systemic bacteremia within the first month following placement.
Materials & Methods
Single institution IRB approved retrospective review of adult patients presenting for port placement. Procedure date, MRN, antibiotic agent, number of lumens, indication, age, and gender were documented. Ports placed and removed within 30 days were investigated. If infection was indication for removal, the following was documented: site infection on removal, bacteremia, cultured agents, and source of culture (blood stream, port site, other). Incidence rates were calculated and compared between the antibiotic vs. no-antibiotic arms. Chi-squared analysis was used for comparison.
Results
5967 port placements were included, of which 61.4% were in women. The mean age of patients undergoing port placement was 59.3 years (SD+/- 14 years). 52% Of removed ports were from women (p=0.1741), at a mean age of 55.3 years. 67% (3978) received antibiotics while 33% (1989) did not.52 ports were removed within 30 days, 29% within the first two weeks and 71% within the last two weeks. 50 of these were due to infection concern, 35 in the antibiotic arm vs 15 in the no-antibiotic arm. Incidence of removal was 0.87% in the antibiotic arm vs 0.75% in the no-antibiotic arm (p= 0.629). There was evidence of site infection on removal in 0.301% of antibiotic arm cases vs 0.298% in the no-antibiotic arm (p=0.9840). 53.3% patients with ports removed from the no-antibiotic arm (8/15) had bacteremia with a skin agent compared with 48.5% (17/35) in the antibiotic arm (p=0.7581).Notably, 26% of removed ports were in patients with primary lymphoma or liquid dyscrasia, compared with 13% incidence of these in the total population (p=0.0067). Otherwise no association was seen between infection rates and placement indication.
Conclusions
Single dose of pre-procedural antibiotics does not prevent against immediate post-procedural local infection or associated skin agent bacteremia. The incidence of infection is higher in patients with lymphoma and/or liquid dyscrasias.