Indwelling pleural catheter infection rate - a single centre experience in a tertiary care Hospital – UK

<bold>Introduction:</bold> Indwelling pleural catheters (IPCs) are frequently used safely as a long-term strategy for managing recurrent malignant and sometimes non-malignant pleural effusion. Although, complications can occur. Pleural infection is reported to occur in less than 5% of patients and usually responds to antibiotics and catheter removal. Rarely, surgery may be required. This study aims to determine the incidence of IPC infection in modern tertiary centre practice and examine for associations with use of systemic anticancer therapy (SACT). <bold>Methods:</bold> A retrospective study was conducted at Oxford University Hospitals to review outcomes of all IPCs inserted between January 2019 and December 2022. <bold>Results:</bold> 244 IPCS were reviewed; 67% were male and the rate of IPC infection was 15, 6.1%. Median time to infection was 58 days(IQR 18 – 247) after IPC insertion. 6, 40% displaying microbiological culture positivity. In 12, 80% of cases, IPC removal was required alongside antibiotics, and 5, 33% required intrapleural fibrinolytics. No patient required surgery. IPC infection in malignant effusions Of all infection patients, 10, 67% had underlying malignancies. 7, 70 % were on SACT when they developed a pleural infection vs 3,30% who were not on SACT (p=0.200, 2 df, chi squared test). IPC infection in non-malignant effusions All patients with non-malignant effusion developed an infection (5). <bold>Conclusion:</bold> IPCs insertion for non malignant effusions should be cautiously considered, as the proportion of patients on SACT with IPC-related infection was higher than those not on treatment. However, this is not statistically significant, and larger, prospective studies are required to delineate this.