Surgical Site Infections in Cancer Patients with Intrathecal Drug Delivery Devices
Surgical Site Infections in Cancer Patients with Intrathecal Drug Delivery Devices
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DOI：
10.1093/pm/pnw203
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发表时间：
2017-03-01
期刊：
影响因子：
3.1
通讯作者：
Lamer, Tim J.
中科院分区：
文献类型：
--
作者：
Scanlon, Maura M.;Gazelka, Halena M.;Lamer, Tim J.
目标.我们的目的是确定接受鞘内给药系统（IDDS）的癌症患者手术部位感染（SSI）的发生率，并将该发生率与接受IDDS或脊髓刺激器的一般人群的SSI发生率进行比较。我们试图从暴露于癌症治疗的角度来描述接受IDDS治疗的癌症患者发生SSI的危险因素。回顾性审查。设置。大型三级护理中心。病人。2006- 2013年接受IDDS的癌症患者。根据美国疾病控制和预防中心的定义确定SSI的发生率。药物治疗方案和目前的癌症治疗进行了调查，以确定免疫功能低下的患者在IDDS放置。对微细菌学、治疗和总体结果进行了调查。2006-2013年，64例患者植入IDDS。4例患者（6.2%）发生SSI。所有四名患者在植入前三个月内接受了化疗或放疗。3例患者正在接受地塞米松治疗，3例患者需要接受IDDS治疗。SSI的发生率处于IDDS已发表感染率的上限。由于改变患者免疫状态的因素，包括伴随使用皮质类固醇、SSI附近的放疗和免疫调节剂的存在，该人群中SSI的风险可能增加。识别和缓解该人群的某些风险因素可能会预防未来患者的感染。
Objectives. Our purpose was to determine the incidence of surgical site infection (SSI) in cancer patients receiving an intrathecal drug delivery system (IDDS) and compare that rate with the incidence of SSI in the general population receiving an IDDS or spinal cord stimulator. We attempted to describe risk factors for SSIs in cancer patients treated with IDDS in terms of exposure to cancer treatments.Design. Retrospective review.Setting. Large tertiary care center.Patients. Cancer patients receiving an IDDS in 2006-2013.Methods. The incidence of SSI was determined according to the US Centers for Disease Control and Prevention definition. Medication regimens and current cancer treatment were investigated to identify immunocompromised patients during IDDS placement. Microbacteriology, treatment, and overall outcomes were investigated.Results. Sixty-four patients had an IDDS implanted in 2006-2013. SSI developed in four patients (6.2%). All four patients had received chemotherapy or radiotherapy within three months before implantation. Three of the three were receiving dexamethasone, and three of the four required explantation of the IDDS.Conclusion. The incidence of SSI was at the upper end of the published infection rates for IDDS. The risk of SSI may be increased in this population because of factors that alter the patient's immune status, including concomitant corticosteroid use, radiotherapy near the SSI, and presence of immunomodulators. The identification and mitigation of certain risk factors for this population may prevent infection in future patients.