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Symptoms and signs of port-related infections in oncology patients related to the offending pathogens.

Liaw CC, Chen JS, Chang HK, Huang JS, Yang TS, Liau CT

Division of Hemato-Oncology, Department of Internal Medicine, Chang-Gung Memorial Hospital and Chang-Gung University, Taipei, Taiwan.

Aim: There is limited information about symptoms and signs of port-related infections linking to their offending pathogens. Methods: Oncology patients proven to have port-related infections were retrospectively analysed. We divided them into two subgroups according to their symptoms and signs. Onset of fever and chills with or without hypotension following the port flush was classified as 'port flush form infection'. Presence of local inflammatory signs, including erythema, warmth, tenderness and pus formation and systemic infection signs, including fever, chills with or without hypotension was classified as 'local inflammatory form infection'. Results: There were 29 episodes of port-related infection among 28 patients, with port flush form 22 episodes and local inflammatory form seven episodes. Of 22 episodes of port flush form infections, 20 (91%) were nosocomial glucose non-fermenting gram-negative bacilli, with Acinetobacter baumannii (11 episodes, 50%) and Enterobacter cloacae (four episodes, 18%) the most common. Polymicrobial infections occurred in four episodes (18%). Candida infection occurred in two episodes (9%). Of seven episodes of local inflammatory form infections, six (86%) were gram-positive cocci, with Staphylococcus aureus (five episodes, 71%) the most common. The time from port implantation to its infection was 272 +/- 255 days (30-993 days) for the port flush form infections and 82 +/- 87 days (22-265 days) for the local inflammatory form infections. This difference was not significant difference (p = 0.068). Conclusions: The differences between infection of patients with port flush form and local inflammatory form in incidence and offending microorganism suggest that the aetiology of infection were different.

Published 21 April 2008 in Int J Clin Pract.
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