Recovery from staphylococcal septicaemia in neutropenic patients without removal of the previously inserted central venous catheter
Karmochkine, M.; Brunet, F.; Lanore, J.J.; Belghit, M.; Mira, J.P.; Dhainaut, J.F.; Monsallier, J.F.
European Journal of Medicine 2(3): 143-147
1993
ISSN/ISBN: 1165-0478 PMID: 8261054 Document Number: 419193
An open clinical study was conducted in the haematological department of an intensive care unit to investigate cure of staphylococcal septicaemia in neutropenic central venous catheter carriers without removal of the line. Thirteen neutropenic patients with a central venous catheter were investigated. These patients were under treatment for haematological malignancies and had at least 2 blood cultures positive for Staphylococcus aureus or coagulase-negative staphylococcus. Antibiotherapy including vancomycin was given through the catheter. Each case was re-evaluated on day 3 of treatment. The catheter was removed if blood cultures remained positive or if clinical signs of bloodstream infection persisted or worsened. Clinical recovery was obtained in ten patients and bacterial eradication in twelve. Three patients died from septic shock: two deaths were not related to staphylococcal septicaemia; one death was due to a staphylococcal septic shock which occurred within a few hours of admission, despite of prompt removal of the central venous catheter. With appropriate antibiotherapy, leaving the central venous catheter in place would appear possible in cases of staphylococcal septicaemia. Response to treatment, however, must be carefully monitored.