Role of Central Venous Catheter in Blood Stream Infections of Patients with High Comorbidity Index
Josephine Anuforo2, Michael Haddadin1, Gwyneth Sultan1, Ellen Oseni1, Jianxiang Xia1, Akeem Lewis1, Iuliana Shapira1. 1SUNY Downstate Medical Center, Syosset, New York, United States, 2Medicine, St. John Episcopal, Far Rockaway, New York, United States
Purpose of Study To estimate the burden of bacterial infections in black inner city minority population with advanced malignancies and/or high comorbidity burden. Multiple comorbidities and cancer are the leading cause of death in Central Brooklyn and a major public health problem for this population and requires a more precise understanding of blood stream infections and their relation to cancer.
Methods Used A retrospective review of consecutive blood stream infections were evaluated as part of performance improvement process to detect trends of microorganism resistance and avoid using inappropriate treatments for infections in cancer patients. Two group of infected patients were analyzed those with central venous catheters, versus those without. Characteristics of patients in different groups were compared using Chi-square or Fisher's exact tests for categorical variables, and Wilcoxon rank-sum test for continuous variables. P ≤ 0.05 (two-tailed) considered statistically significant. A multivariable logistic regression model was constructed to identify baseline factors independently associated with one year mortality. All variables with P ≤ 0.1 in univariate analysis were entered into the multivariable model and a backward stepwise selection process applied. SPSS, version 22.0 (IBM SPSS, IBM Corporation, Somers, NY) used for all statistical analyses.
Summary of Results Bacterial stream infections in black inner-city patients with Charlson comorbidity index >7 occur as frequent in patients with and without central venous catheter rate of (28%; 33% p = 0.1) In black patients with advanced malignancies defined by metastatic disease epithelial barrier disruption (EBD) is a source of blood stream infections. Our study shows that finessing understanding of nosocomial infection in population of cancer patients with high burden of comorbidity is needed.
Conclusions In black patients with advanced malignancies defined by metastatic disease epithelial barrier disruption (EBD) is a source of blood stream infections. Our study shows that finessing understanding of nosocomial infection in population of cancer patients with high burden of comorbidity is needed.
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