Preventing catheter-related infections in cancer patients: a review of current strategies

ABSTRACT

Introduction

Central line-associated bloodstream infections (CLABSI) are a frequent cause of healthcare-associated infections, increasing healthcare costs and decreasing the quality of life for critically and chronically ill patients such as those with cancer. These infections are largely preventable and have been significantly reduced throughout the United States. However, further reduction of CLABSI requires continued innovation in preventive strategies.

Areas covered

We provide an overview of the recent medical literature on catheter-related infections among cancer patients, discussing epidemiology, risk factors, and pathogenesis of CLABSI with a focus on the newest and current preventive measures. The data discussed here were retrieved mainly from clinical trials, meta-analyses, and systematic reviews published in the English language using a MEDLINE database search from 1 January 1990 until the end of December 2019.

Expert opinion

The growing impact of CLABSI on the healthcare setting and mortality and morbidity rates in cancer patients calls for novel technologies for preventing central line-related infections. Advances in antimicrobial lock therapy are not limited to salvage therapy but have also provided a novel and promising prophylactic approach to CLABSI. Also, the use of antimicrobial-coated catheters with chlorhexidine-impregnated dressings, along with the application of insertion and maintenance bundles, is an effective and cost-effective approach for preventing central line-related infections.

KEYWORDS:

• Central line-associated bloodstream infection
• biofilm formation
• insertion bundle
• maintenance bundle
• antimicrobial lock therapy
• antimicrobial-coated central venous catheters

Article highlights

• Central line–associated bloodstream infection (CLABSI) is common in cancer patients and is the main cause of healthcare-associated infections.

• CLABSI is preventable and requires a multidisciplinary effort in implementing preventive approaches.

• Adherence to practice-based evidence, including the use of antimicrobial-coated catheters, chlorhexidine-impregnated dressings, sutureless securement devices for central venous catheters, and removal of unnecessary central venous catheters has been shown to significantly reduce the incidence of CLABSI.

• The novel technology of antimicrobial lock therapy is becoming a crucial intervention in preventing central line-related infection.

Acknowledgments

We thank Ms. Sarah Bronson in Scientific Publications, Research Medical Library at The University of Texas MD Anderson Cancer Center for her time in reviewing and editing the manuscript.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper was not funded.