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Espitia O, Raimbeau A, Planquette B, Katsahian S, Sanchez O, Espinasse B, Bénichou A, Murris J. A systematic review and meta-analysis of the incidence of post-thrombotic syndrome, recurrent thromboembolism, and bleeding after upper extremity vein thrombosis. J Vasc Surg Venous Lymphat Disord 2024; 12:101688. [PMID: 37717788 DOI: 10.1016/j.jvsv.2023.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 08/26/2023] [Accepted: 09/04/2023] [Indexed: 09/19/2023]
Abstract
BACKGROUND Data on complications after upper extremity vein thrombosis (UEVT) are limited and heterogeneous. METHODS The aim of the present study was to evaluate the pooled proportions of venous thromboembolism (VTE) recurrence, bleeding, and post-thrombotic syndrome (PTS) in patients with UEVT. A systematic literature review was conducted of PubMed, Embase, and the Cochrane Library databases from January 2000 to April 2023 in accordance with the PRISMA (preferred reporting items for systematic reviews and meta-analyses) guidelines. All studies included patients with UEVT and were published in English. Meta-analyses of VTE recurrence, bleeding, and of PTS after UEVT were performed to compute pooled estimates and associated 95% confidence intervals (CIs). Subgroup analyses of cancer-associated UEVT and catheter-associated venous thrombosis were conducted. Patients with Paget-Schroetter syndrome or effort thrombosis were excluded. RESULTS A total of 55 studies with 15,694 patients were included. The pooled proportions for VTE recurrence, major bleeding, and PTS were 4.8% (95% CI, 3.8%-6.2%), 3.0% (95% CI, 2.2%-4.0%), and 23.8% (95% CI, 17.0%-32.3%), respectively. The pooled proportion of VTE recurrence was 2.7% (95% CI, 1.6%-4.6%) for patients treated with direct oral anticoagulants (DOACs), 1.7% (95% CI, 0.8%-3.7%) for patients treated with low-molecular-weight heparin (LMWH), and 4.4% (95% CI, 1.5%-11.8%) for vitamin K antagonists (VKAs; P = .36). The pooled proportion was 6.3% (95% CI, 4.3%-9.1%) for cancer patients compared with 3.1% (95% CI, 2.1%-4.6%) for patients without cancer (P = .01). The pooled proportion of major bleeding for patients treated with DOACs, LMWH, and VKAs, was 2.1% (95% CI, 0.9%-5.1%), 3.2% (95% CI, 1.4%-7.2%), and 3.4% (95% CI, 1.4%-8.4%), respectively (P = .72). The pooled proportion of PTS for patients treated with DOACs, LMWH, and VKAs was 11.8% (95% CI, 6.5%-20.6%), 27.9% (95% CI, 20.9%-36.2%), and 24.5% (95% CI, 17.6%-33.1%), respectively (P = .02). CONCLUSIONS The results from this study suggest that UEVT is associated with significant rates of PTS and VTE recurrence. Treatment with DOACs might be associated with lower PTS rates than treatment with other anticoagulants.
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Affiliation(s)
- Olivier Espitia
- Department of Vascular Medicine, Nantes Université, CHU Nantes, l'institut du Thorax, INSERM UMR1087/CNRS UMR 6291, Team III Vascular & Pulmonary Diseases, Nantes, France; UNAV, Nantes Vascular Access Unit, Nantes Université, CHU Nantes, Nantes, France.
| | - Alizée Raimbeau
- Department of Vascular Medicine, Nantes Université, CHU Nantes, l'institut du Thorax, INSERM UMR1087/CNRS UMR 6291, Team III Vascular & Pulmonary Diseases, Nantes, France; UNAV, Nantes Vascular Access Unit, Nantes Université, CHU Nantes, Nantes, France
| | - Benjamin Planquette
- Service de Pneumologie et Soins Intensifs, Hôpital Européen Georges Pompidou, AP-HP, Centre - Université Paris Cité, INSERM UMR S1140, Innovative Therapies in Hemostasis, Paris, France, F-CRIN INNOVTE, Université Paris Cité, St-Etienne, France
| | - Sandrine Katsahian
- INSERM, Centre d'Investigation Clinique 1418 (CIC1418) Epidémiologie Clinique, AP-HP, Hôpital Européen Georges Pompidou, Unité de Recherche Clinique, Service d'Informatique Médicale, Biostatistiques et Santé Publique, AP-HP Centre, Paris, France; Inserm, Centre de Recherche des Cordeliers, Université de Paris, Sorbonne Université, Paris, France; HeKA, Inria, Paris, France
| | - Olivier Sanchez
- Service de Pneumologie et Soins Intensifs, Hôpital Européen Georges Pompidou, AP-HP, Centre - Université Paris Cité, INSERM UMR S1140, Innovative Therapies in Hemostasis, Paris, France, F-CRIN INNOVTE, Université Paris Cité, St-Etienne, France
| | | | - Antoine Bénichou
- Department of Vascular Medicine, Nantes Université, CHU Nantes, l'institut du Thorax, INSERM UMR1087/CNRS UMR 6291, Team III Vascular & Pulmonary Diseases, Nantes, France; UNAV, Nantes Vascular Access Unit, Nantes Université, CHU Nantes, Nantes, France
| | - Juliette Murris
- Inserm, Centre de Recherche des Cordeliers, Université de Paris, Sorbonne Université, Paris, France; HeKA, Inria, Paris, France; RWE and Data, Pierre Fabre, Boulogne-Billancourt, France
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Visek J, Ryskova L, Machacova A, Marikova M, Blaha V. In vitro comparison of the effectiveness of various antimicrobial locks with taurolidine in the treatment and prevention of catheter-related bloodstream infections in patients receiving parenteral nutrition. Nutrition 2023; 114:112115. [PMID: 37450960 DOI: 10.1016/j.nut.2023.112115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 06/01/2023] [Indexed: 07/18/2023]
Abstract
OBJECTIVES To evaluate the effectiveness of various taurolidine solutions in the prevention and treatment of catheter-related bloodstream infections (CRBSIs) caused by the entire spectrum of microbes in patients receiving parenteral nutrition in a shorter period of time. METHODS The in vitro method was used to test for eradication of biofilm. Different locks were used: TauroSept (2%), TauroLock (1.35%), TauroLock half concentration, and 3.5% taurolidine and tested on Staphylococcus (S.) epidermidis, S. aureus, S. hominis, methicillin-resistant S. aureus (MRSA), Pseudomonas (P.) aeruginosa (PSAE), multidrug-resistant P. aeruginosa (MR PSAE), vancomycin-resistant enterococci, Klebsiella pneumoniae producing carbapenemase (KPC), Klebsiella pneumoniae producing extended-spectrum beta-lactamase (KLPN ESBL), Candida (C.) albicans, and C. glabrata. Broviac catheters were incubated for growth of each organism and then incubated in lock solutions. Colony forming units (CFUs) were then counted after 30 min, 60 min, and 120 min of incubation. RESULTS A statistically significant decrease in CFUs was observed after 30 min of taurolidine exposure for S. hominis, PSAE, KLPN ESBL, KLPN KPC, C. albicans, and C. glabrata; after 60 min of exposure for S. epidermidis, PSAE, MR PSAE, KLPN ESBL, KPC, C. albicans, and C. glabrata; and after 120 min of exposure for S. epidermidis, S. hominis, S. aureus, PSAE, MR PSAE, KLPN ESBL, KPC, C. albicans, C. glabrata. CONCLUSIONS The application of taurolidine is effective in the treatment of CRBSIs. Taurolidine proved to be more effective against Gram-negative microorganisms during a 30-min exposure. Using 0.675% taurolidine is still effective. To achieve the required antimicrobial effect, the catheter must be sanitized for at least 2 h.
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Affiliation(s)
- Jakub Visek
- Department of Gerontology and Metabolism, University Hospital and Medical Faculty in Hradec Kralove, Charles University in Prague, Czech Republic.
| | - Lenka Ryskova
- Department of Clinical Microbiology, University Hospital and Medical Faculty in Hradec Kralove, Charles University in Prague, Czech Republic
| | - Alena Machacova
- Department of Clinical Microbiology, University Hospital and Medical Faculty in Hradec Kralove, Charles University in Prague, Czech Republic
| | - Martina Marikova
- Department of Clinical Pharmacy, Regional Hospital Trutnov, Trutnov, Czech Republic; Department of Social and Clinical Pharmacy, Charles University, Faculty of Pharmacy in Hradec Kralove, Hradec Kralove, Czech Republic
| | - Vladimir Blaha
- Department of Gerontology and Metabolism, University Hospital and Medical Faculty in Hradec Kralove, Charles University in Prague, Czech Republic; Integrity Nutraceuticals International, Spring Hill, Tennessee, USA
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Santos-Ontiveros A, Reyes-Sánchez I, Hernández-Luevano E, Vega-Cruz ME, González-Marín EC, Chávez-López EL, Arenas-Osuna J, Medina-Gómez OS, García-Covarrubias L, Paniagua-Sierra JR, Hernández-Rivera JCH. Survival of Vascular Accesses in Chronic Hemodialysis Patients. Blood Purif 2020; 50:552-559. [PMID: 33361698 DOI: 10.1159/000512119] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 10/02/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND/AIMS Vascular access (VA) is the highest risk factor for blood infections, hospitalization, and mortality of patients undergoing hemodialysis (HD). The risk of mortality while using a catheter is greater than that while using grafts. The objective of this article is to know the survival rate in relation to the type of VA. METHODS A retrospective cohort of HD patients was studied. The data gathered included age, gender, first VA at the surrogate site, days between the first and second access, number of accesses, and anatomical site of VA placement. Mean differences were estimated using χ2 or Student's t test. Survival was calculated using the Kaplan-Meier curves and included in tables. Statistical significance was established as p < 0.05. The statistical computer software package SPSSw v25 was used for the analysis. RESULTS A total of 896 patients were included with a mean age of 47.88 years (SD ± 16.52), the duration of the first VA was 398.81 days (±565.79), the mean number of VAs used was 2.26 (±1.15), and the median time undergoing HD was 728.73 days. The duration of catheter placement was 330.42 days, and 728.60 days for fistula use (p = 0.001). The mean number of days of renal replacement was 611.59 days for catheter and 1,495.25 days for internal arteriovenous fistula (IAVF) patients (p = 0.001). CONCLUSIONS The survival of the initial VA is greater for the IAVF, followed by the tunneled catheters and the lowest by the non-tunneled catheters, which continue to be frequently used in our setting.
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Affiliation(s)
- Abraham Santos-Ontiveros
- Servicios Médicos y de Equipamiento S.A. de C.V. (Medical Services and Equipment, S.A. de C.V.), State of Mexico (Estado de México), Mexico City, Mexico
| | - Ivonne Reyes-Sánchez
- Nephrology Service, Specialties Hospital, "La Raza" National Medical Center, Mexican Institute of Social Security (IMSS) (Servicio de Nephrología, Hospital de Especialidades Centro Médico La Raza, IMSS - Instituto Mexicano del Seguro Social), Mexico City, Mexico
| | - Emmanuel Hernández-Luevano
- Servicios Médicos y de Equipamiento S.A. de C.V. (Medical Services and Equipment, S.A. de C.V.), State of Mexico (Estado de México), Mexico City, Mexico
| | - Martin E Vega-Cruz
- Servicios Médicos y de Equipamiento S.A. de C.V. (Medical Services and Equipment, S.A. de C.V.), State of Mexico (Estado de México), Mexico City, Mexico
| | - Edna C González-Marín
- Servicios Médicos y de Equipamiento S.A. de C.V. (Medical Services and Equipment, S.A. de C.V.), State of Mexico (Estado de México), Mexico City, Mexico
| | - Ernesto L Chávez-López
- Nephrology Service, Specialties Hospital, "La Raza" National Medical Center, Mexican Institute of Social Security (IMSS) (Servicio de Nephrología, Hospital de Especialidades Centro Médico La Raza, IMSS - Instituto Mexicano del Seguro Social), Mexico City, Mexico
| | - Jesús Arenas-Osuna
- Health Education and Research Department, Specialties Hospital, "La Raza" National Medical Center, Mexican Institute of Social Security (IMSS) (Jefatura de Educación e Investigación en Salud Hospital de Especialidades Centro Médico La Raza, IMSS), Mexico City, Mexico
| | - Oswaldo S Medina-Gómez
- Clinical Epidemiology Research Unit, "Carlos Mac Gregor" Zone No. 1 General Hospital (Unidad de Investigación en Epidemiología Clínica, Hospital General de Zona No. 1 Carlos Mac Gregor), Mexico City, Mexico
| | | | - José R Paniagua-Sierra
- Medical Research Unit on Nephrological Diseases, Specialties Hospital, 21st Century National Medical Center, Mexican Institute of Social Security (IMSS) (Unidad de Investigación Médica en Enfermedades Nefrológicas, Hospital de Especialidades Centro Médico Nacional Siglo XXI, IMSS), Mexico City, Mexico
| | - Juan Carlos H Hernández-Rivera
- Medical Research Unit on Nephrological Diseases, Specialties Hospital, 21st Century National Medical Center, Mexican Institute of Social Security (IMSS) (Unidad de Investigación Médica en Enfermedades Nefrológicas, Hospital de Especialidades Centro Médico Nacional Siglo XXI, IMSS), Mexico City, Mexico,
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Cobo F, Zaragoza Ó, Navarro-Marí JM. Rhodotorula dairenensis fungemia in a patient with cancer. Rev Iberoam Micol 2020; 37:63-64. [PMID: 32546314 DOI: 10.1016/j.riam.2020.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 02/23/2020] [Accepted: 03/23/2020] [Indexed: 10/24/2022] Open
Abstract
BACKGROUND Rhodotorula species were traditionally considered non-virulent environmental microorganisms, but are nowadays considered important human pathogens, especially in immunocompromised individuals. CASE REPORT We present the case of a 73 year-old man with diarrhea, anorexia and fever. In the blood analyses, both aerobic blood culture bottles yielded the growth of Rhodotorula dairenensis. The MALDI-TOF MS score was inadequate to provide an identification, which was achieved by means of molecular techniques. Treatment with an echinocandin was started, but the patient died. CONCLUSIONS Basidiomycetous yeast genera such as Rhodotorula can cause invasive and severe infections, e.g., fungemia, especially in patients with central venous catheter or another indwelling device.
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Affiliation(s)
- Fernando Cobo
- Department of Microbiology and Instituto Biosanitario, University Hospital Virgen de las Nieves, Granada, Spain.
| | - Óscar Zaragoza
- Centro Nacional de Microbiología. Majadahonda, Madrid, Spain
| | - José María Navarro-Marí
- Department of Microbiology and Instituto Biosanitario, University Hospital Virgen de las Nieves, Granada, Spain
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Sieverding L, Busch A, Gesche J, Blumenstock G, Sturm E, Tsiflikas I, Piersma F, Hauser A, Wiegand G, Hartleif S, Hofbeck M, Fuchs J, Warmann SW. Hybrid interventions for catheter placement in pediatric intestinal rehabilitation patients with end-stage venous access. J Pediatr Surg 2018; 53:553-7. [PMID: 28365108 DOI: 10.1016/j.jpedsurg.2017.03.051] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Revised: 02/23/2017] [Accepted: 03/19/2017] [Indexed: 11/23/2022]
Abstract
PURPOSE The purpose of this study is to analyze the combined approach of endovascular and open surgical procedures for insertion of permanent central venous catheters in children with intestinal failure and end-stage venous access. METHODS Data of 14 children (16 interventions) with intestinal failure and end-stage venous access, treated within the pediatric intestinal rehabilitation program at our institution between September 2011 and November 2016, were retrospectively reviewed. The patients underwent hybrid endovascular/open surgical approaches for insertion of central venous catheters. Access to central veins was established through endovascular intervention; catheter placement was achieved with combined interventional and surgical measures depending on the individual vascular conditions. RESULTS Median age at intervention was 47months (interquartile range (IQR),29-74), median time for interventions was 66min (IQR,42-111). Catheter placement was successfully achieved in all patients. The median dose of irradiation during angiography was 0.2Gy*cm2 (IQR, 0.2-0.6), no complications occurred during or after interventions. CONCLUSIONS Hybrid endovascular/open surgical procedures can be successfully applied for restoring or maintaining permanent central venous catheters in children with intestinal failure and end-stage venous access. These approaches are a valuable contribution in intestinal rehabilitation programs contributing to a further decrease of the need for intestinal transplantation in affected patients. TYPE OF STUDY Treatment Study. LEVEL OF EVIDENCE Level IV.
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Marcy PY, Dahlet C, Brenet O, Yazbec G, Dubois PY, Salm B, Fouche Y, Mari V, Montastruc M, Lebrec N, Ancel B, Paillocher N, Dupoiron D, Rangeard O, Michel C, Chateau Y, Ettaiche M, Ferrero JM, Chamorey E. [Multicenter validation study of a questionnaire assessing patient satisfaction with and acceptance of totally-implanted central venous access devices]. Bull Cancer 2015; 102:301-15. [PMID: 25799876 DOI: 10.1016/j.bulcan.2015.02.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2014] [Accepted: 01/29/2015] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Most cancer patients require a totally-implanted central venous access device (TIVAD) for their treatment. This was a prospective, multicenter, open study to: (i) develop and validate a French-language questionnaire dubbed QASICC (Questionnaire for Acceptance of and Satisfaction with Implanted Central Venous Catheter) assessing patient's satisfaction with and acceptance of their TIVAD; (ii) develop a mean score of patient's acceptance and satisfaction; (iii) look for correlation between QASICC score and TIVAD patient/tumor pathology/device characteristics. METHODS From 2011 November to 2012 December, the first version of the QASICC questionnaire that included 27 questions assessing seven dimensions was re-tested among 998 cancer patients in eleven French cancer hospitals (eight cancer research institutes and three university/general hospitals). The goal was: (i) to reduce the questionnaire item and dimension number (pertinency, saturation effect, item correlation); (ii) to assess its psychometric properties, demonstrate its validity and independency compared to (EORTC) QLQC30; (iii) to correlate clinical and pathological patient's/tumor's/TIVAD's parameters with the QASICC questionnaire score (the higher the overall score, the greater the acceptance and satisfaction). The questionnaire was administered to the patient 30 days (±15 days) after TIVAD's implantation. RESULTS Among 998 questionnaires given to cancer patients, 658 were analyzed and 464 were fully assessed as there was no missing data. Time to fill-in the questionnaire was five minutes in 90% patients. Final QASICC tool included twenty-two questions assessing four homogeneous dimensions (65%<Cronbach coefficient<85%): (i) impact on daily activities and professional activities; (ii) esthetics and privacy; (iii) pain, contribution to the comfort of the treatment; (iv) local discomfort. Respective assessment scores were 23.6%, 32.9%, 20.4% and 18.0%. Overall satisfaction score was 75.8%; global assessment score was 76.2%. These scores were significantly linked to patient's gender, anesthesia type, TIVAD's implantation side, patient's age and tumor type. CONCLUSIONS This second and final methodological and statistical validation of this auto-questionnaire QASICC allows us to propose it as a dedicated questionnaire to TIVAD's cancer patients by using a score assessing acceptance and satisfaction regarding their device.
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Affiliation(s)
- Pierre Yves Marcy
- Centre Antoine-Lacassagne, 33, avenue de Valombrose, 06189 Nice cedex 1, France.
| | - Christian Dahlet
- Centre Paul-Strauss, 03, rue de la Porte de l'Hôpital, 67065 Strasbourg cedex, France
| | - Olivier Brenet
- Centre Paul-Papin, ICO, 2, rue Moll, 49933 Angers cedex 9, France
| | - Gabriel Yazbec
- Institut Jean-Godinot, 01, avenue du Général-Koenig, BP171, 51056 Reims cedex, France
| | - Pierre Yves Dubois
- Institut Jean-Godinot, 01, avenue du Général-Koenig, BP171, 51056 Reims cedex, France
| | - Bernard Salm
- Centre Alexis-Vautrin, 6, avenue de Bourgogne, 54511 Vandœuvre-lès-Nancy, France
| | - Yves Fouche
- Centre Antoine-Lacassagne, 33, avenue de Valombrose, 06189 Nice cedex 1, France
| | - Veronique Mari
- Hôpital de Jour, centre Antoine-Lacassagne, 33, avenue de Valombrose, 06189 Nice cedex 1, France
| | - Marion Montastruc
- Institut Claudius-Rigaud, 20-24, rue du Pont-Saint-Pierre, 31052 Toulouse cedex, France
| | - Nathalie Lebrec
- Centre Paul-Papin, ICO, 2, rue Moll, 49933 Angers cedex 9, France
| | - Benoit Ancel
- Centre Alexis-Vautrin, 6, avenue de Bourgogne, 54511 Vandœuvre-lès-Nancy, France
| | | | - Denis Dupoiron
- Centre Paul-Papin, ICO, 2, rue Moll, 49933 Angers cedex 9, France
| | - Olivier Rangeard
- Centre Alexis-Vautrin, 6, avenue de Bourgogne, 54511 Vandœuvre-lès-Nancy, France
| | - Cécile Michel
- Unité de recherche clinique, département de recherche clinique, innovation et statistiques, centre Antoine-Lacassagne, 33, avenue de Valombrose, 06189 Nice cedex 02, France
| | - Yann Chateau
- Unité d'épidémiologie et de biostatistiques, département de recherche clinique, innovation et statistiques, centre Antoine-Lacassagne, 33, avenue de Valombrose, 06189 Nice cedex 02, France
| | - Marc Ettaiche
- Unité d'épidémiologie et de biostatistiques, département de recherche clinique, innovation et statistiques, centre Antoine-Lacassagne, 33, avenue de Valombrose, 06189 Nice cedex 02, France
| | - Jean-Marc Ferrero
- Unité de recherche clinique, département de recherche clinique, innovation et statistiques, centre Antoine-Lacassagne, 33, avenue de Valombrose, 06189 Nice cedex 02, France
| | - Emmanuel Chamorey
- Unité d'épidémiologie et de biostatistiques, département de recherche clinique, innovation et statistiques, centre Antoine-Lacassagne, 33, avenue de Valombrose, 06189 Nice cedex 02, France
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Shelburne SA, Chaftari AM, Jamal M, Al Wohoush I, Jiang Y, Abughazaleh S, Cairo J, Raad S, Debiane L, Raad I. Identification and characterization of catheter-related bloodstream infections due to viridans group streptococci in patients with cancer. Am J Infect Control 2014; 42:1127-9. [PMID: 25278410 DOI: 10.1016/j.ajic.2014.06.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2014] [Revised: 06/05/2014] [Accepted: 06/16/2014] [Indexed: 10/24/2022]
Abstract
Viridans group streptococci (VGS), a leading cause of bloodstream infection (BSI) in cancer patients, are thought to arise from the gastrointestinal tract. We sought to determine whether central venous catheters may serve as the source of VGS BSI, and to compare the ability of the newly proposed mucosal barrier injury laboratory-confirmed BSI definition to assign a VGS BSI source compared with the catheter-related BSI definition.
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