Risk factors for infection of totally implantable central venous access ports among patients requiring port removal

Abstract

Background: Totally implantable central venous access ports, are required for various purposes, ranging from chemotherapy to nutrition. Port infection is a common complication. In many patients with port infection, the ports are removed because antibiotics are ineffective. We evaluated the risk factors associated with port removal due to port infection. Methods: By retrospective chart review, we collected data of 223 patients who underwent port removal for any reason. Port infection was defined as infection symptoms, such as fever; elevated white blood cell counts or C-reactive protein levels; or redness at the port site, in the absence of other infections, which improved with port removal. The characteristics of patients with or without port infection were compared using univariate (chi-squared test, t-test) and multivariate logistic regression analyses. Results: We compared 172 patients without port infection to 51 patients with port infection. Univariate analysis identified sex ( p = 0.01), body mass index (BMI) ⩽20 kg/m2 ( p = 0.00004), diabetes mellitus ( p = 0.04), and purpose of use ( p = 0.0000003) as significant variables. However, male sex ( p = 0.03, 95% confidence interval [CI]: 0.01–0.23), BMI ⩽20 kg m2 ( p = 0.002, 95% CI: 0.06–0.29), and purpose of use (total parenteral nutrition (TPN); p = 0.000005, 95% CI: 0.31–0.76) remained significant using multivariate analysis. Moreover, the patients with short bowel syndrome and difficulty in oral intake tended to be infected easily. Additionally, Staphylococcus species were the most common microbes involved in port infection. Conclusions: Male sex, BMI ⩽20 kg/m2, and purpose of use as a TPN were risk factors for port infection. Ports should not be used for long duration of TPN or used only in exceptional cases.