Overweight or obesity are not risk factors for central venous catheter–related bloodstream infections in patients with hematological malignancies

To the Editor—In 2015, we reported on the risk of central venous catheter (CVC)–related bloodstream infections (CRBSIs) in obese patients with hematological malignancies.1 Considering together definite, probable, and possible CRBSIs,2 we detected no difference in the CRBSI rate between obese and nonobese patients (22.1% vs 23.3%).1 However, this analysis was based on only 335 CVC cases from the Magdeburg cohort of the SECRECY registry (German Clinical Trial Register, no. Patients/CVCs Characteristics and CRBSI Features Parameter Control Cohort (n=347) Overweight Cohort (n=405) Obesity Cohort (n=294) Median BMI, kg/m2 (range) 22 (19–24) 27 (25–29) 33 (30–56) Median age, y (IQR) 55 (40–63) 61 (54–67) 59 (50–64) Sex, male, n/N (%) 198/347 (57.1) 276/405 (68.1) 162/294 (55.1) Underlying diseases, n/N (%) Acute leukemia 209/347 (60.2) 191/405 (47.2) 137/294 (46.6) Lymphoma 63/347 (18.2) 67/405 (16.5) 39/294 (13.3) Multiple myeloma 51/347 (14.7) 118/405 94/294 (32.0) Myeloproliferative neoplasm 1/347 (0.3) (2/405 (0.5)29.1) 0 Myelodysplastic syndrome 2/347 (0.6) 6/405 (1.5) 3/294 (1.0) Others 21/347 (6.1) 21/405 (5.2) 21/294 (7.1) Neutropeniaa at CVC insertion, n/N (%) 79/347 (22.8) 80/405 (19.8) 66/294 (22.4) Neutropeniaa at infection, n/N (%) CRBSIb 23/26 (88.5) 41/49 (83.7) 28/30 (93.3) dCRBSI 7/8 (87.5) 21/23 (91.3) 8/9 (88.9) Chlorhexidine-coated CVC dressing, n/N (%) 340/347 (98.0) 404/405 (99.8) 288/294 (98.0) Antimicrobial-coated CVC, n/N (%) 5/347 (1.4) 3/405 (0.7) 5/294 (1.7) Jugular vein CVC, n/N (%) 339/347 (97.7) 397/405 (98.0) 291/294 (99.0) CVC days, median (IQR) 17 (8–23) 17 (9–21) 14 (7.75–21) Median time to onset, d (IQR) CRBSIb 11 (7.75–16.25) 12 (6–19) 11 (9.75–14.25) dCRBSI 10.5 (6.75–22.25) 12 (10–14) 12 (10–15.5) Infection rate, n/N (%) CRBSIb 26/347 (7.5) 49/405 (12.1) 30/294 (10.2) (P=.04c) (P=.23c) HR, 1.66 (95% CI, 1.03–2.68) HR, 1.26 (95% CI, 0.97–1.64) (P=.04) (P=.09) 23/405 (5.7) 9/294 (3.1) dCRBSI 8/347 (2.3) (P=.02d) (P=.56c) HR, 2.48 (95% CI, 1.11–5.54) HR, 1.26 (95% CI, 0.78–2.03) (P=.03) (P=.35) Infection incidence, x per 1,000 CVC days CRBSIb 4.5 7.4 7.0 (P=.04c) (P=.10c) dCRBSI 1.4 3.5 2.1 (P=.02c) (P=.41c) Causative CRBSI b pathogens, n/N (%) Coagulase-negative staphylococci 22/26 (84.6) 36/49 (73.5) 26/30 (86.7) Enterobacteriaceae 2/26 (7.7) 1/49 (2.0) 0 Other Gram-negative pathogens 0 3/49 (6.1) 0 Other Gram-positive pathogens 2/26 (7.7) 8/49 (16.3) 3/30 (10.0) Multibacterial 0 1/49 (2.0) 1/30 (3.3) The median number of CV