       Document 0227
 DOCN  M9440227
 TI    Central venous catheter infections in AIDS patients receiving treatment
       for cytomegalovirus disease.
 DT    9404
 AU    Stanley HD; Charlebois E; Harb G; Jacobson MA; Department of Medicine,
       University of California, San Francisco.
 SO    J Acquir Immune Defic Syndr. 1994 Mar;7(3):272-8. Unique Identifier :
       AIDSLINE MED/94149562
 AB    Central venous catheters (CVC) are commonly used to deliver daily
       intravenous medications to patients with AIDS, and CVC-associated
       bacterial infections have been a cause of substantial morbidity in such
       patients. Although previous studies have reported rates of
       CVC-associated infections in AIDS patients, none has compared rates by
       type of intravenous drug regimen used or by whether CVCs were
       percutaneously placed or tunneled under the skin. The charts of all AIDS
       patients diagnosed with cytomegalovirus (CMV) end-organ disease at San
       Francisco General Hospital between 1985 and 1990 were reviewed for
       evidence of CVC use and CVC-associated infection. Infection rates and
       time to infection were analyzed for serious CVC-associated infections
       (requiring catheter removal or hospitalization for intravenous
       antibiotic therapy) by type of anti-CMV therapy administered
       (ganciclovir versus foscarnet) and by type of CVC (tunneled versus
       percutaneous placement). Fifty-four patients had 72 CVCs in use for
       11,622 days of intravenous anti-CMV therapy. There were 36
       CVC-associated infections of which 23 were categorized as serious (rate,
       0.20/100 catheter days). In patients receiving either ganciclovir or
       foscarnet therapy, we found no significant difference in serious
       infection rates or in infection-free survival time (216 vs. 282 days, p
       = 0.7). However, serious CVC infection-free time was significantly
       longer in patients with tunneled than with percutaneous CVCs (419 vs.
       195 days, p = 0.018). The use of ganciclovir compared to foscarnet in
       the treatment of AIDS-related CMV disease was not associated with a
       greater risk of serious catheter-related infection.(ABSTRACT TRUNCATED
       AT 250 WORDS)
 DE    *AIDS-Related Opportunistic Infections  Bacterial
       Infections/EPIDEMIOLOGY/*ETIOLOGY  Catheterization, Central
       Venous/*ADVERSE EFFECTS  Catheters, Indwelling/ADVERSE EFFECTS
       Comparative Study  Cytomegalovirus Infections/COMPLICATIONS/*DRUG
       THERAPY  Foscarnet/ADMINISTRATION & DOSAGE/THERAPEUTIC USE
       Ganciclovir/ADMINISTRATION & DOSAGE/THERAPEUTIC USE  Human  Incidence
       Leukocyte Count  Neutrophils  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

