W. Achour - Academia.edu (original) (raw)
Papers by W. Achour
AbstractObjectives. – Investigation of the occurrence and antibiotic susceptibility of Enterococc... more AbstractObjectives. – Investigation of the occurrence and antibiotic susceptibility of Enterococcus faecium isolates, collected during four years fromneutropenic patients at the Tunisian bone marrow transplantation centre.Materials and methods. – E. faecium strains were identified by conventional methods and by the Api20 Strep (Bio-Merieux, France). Antibioticsusceptibility was determined by the disk diffusion method on Mueller-Hinton agar and interpreted as recommended by CA-SFM. MICs ofampicillin, vancomycin, and teicoplanin were determined by E-test method.Results. – TwohundredandthirtyfiveE.faeciumisolateswererecoveredfromstoolculturesorrectalswabs(229),throat(three),urine(two),andpus of wound (one). None was responsible for bacteraemia. Ampicillin resistance, without production of b-lactamase, was observed in 43.8% ofisolates. All the isolates were susceptible to glycopeptides. High rates of resistance were observed: high-level resistance (HLR) to gentamicin(33.6%), HLR to kanamy...
Imaging of Spinal Infection, 2021
Salmonella osteomyelitis is uncommon and generally associated with sickle cell disease. Vertebral... more Salmonella osteomyelitis is uncommon and generally associated with sickle cell disease. Vertebral location is extremely rare and has mainly been reported in case reports. Magnetic resonance imaging (MRI) is the modality of choice for assessing discovertebral and soft tissue abnormalities. Imaging features are similar to other spondylodiscitis. Bacteria isolation is necessary for definitive diagnosis and antibiotic susceptibility testing, allowing adequate medical treatment.
L'infection a cytomegalovirus (CMV) represente la complication infectieuse la plus frequente ... more L'infection a cytomegalovirus (CMV) represente la complication infectieuse la plus frequente et la plus redoutable chez les patients greffes de moelle osseuse. Le risque majeur etant represente par la maladie a CMV qui, une fois declaree, est pourvoyeuse d'une morbidite et d'une mortalite elevees, malgre le traitement. Plusieurs techniques sont utilisees pour faire le diagnostic de reactivation afin d'initier le plus precocement possible un traitement antiviral pre-emptif. Toutes ces techniques se basent sur l'evaluation de la charge virale qui represente un marqueur fiable pour le diagnostic d'une reactivation et pour le monitorage du traitement. Apres un rappel sur le CMV, nous presentons dans cette revue les differentes methodes et les techniques utilisees pour le depistage de cette reactivation en degageant leurs avantages et leurs inconvenients.
Multidrug Resistant Bacteremia: Clinical And Bacteriological Epidemiology In Hematopoietic Stem C... more Multidrug Resistant Bacteremia: Clinical And Bacteriological Epidemiology In Hematopoietic Stem Cell Transplant Recipients Mellouli A*1,2, Chebbi Y1,2, Fatmi R EL2,3, Radaoui A1,2, LAKHAL A2,3, Torjemane L2,3, Ben Abeljelil N2,3, Belloumi D2,3, Ladeb S2,3, Ben Othman T2,3, Achour W1,2 1Service Des Laboratoires, Centre National De Greffe De Moelle Osseuse, Tunis, Tunisia 2Faculte De Medecine De Tunis, Universite De Tunis El Manar, LR18ES39, Tunis, Tunisia 3Service D’Hematologie, Centre National De Greffe De Moelle Osseuse, Tunis, Tunisia
Twelve multidrug-resistant Pseudomonas aeruginosa (MDRPA) isolates were recovered over a period o... more Twelve multidrug-resistant Pseudomonas aeruginosa (MDRPA) isolates were recovered over a period of two years in the National Bone Marrow Transplant Centre of Tunisia. MDRPA isolates were isolated from seven patients and from three environmental samples. Isoelectric focusing revealed pIs of 8.2, 5.5 and 7.6 in all MDRPA isolates. These strains produced the OXA-18 extended spectrum b-lactamase and an SHV type b-lactamase as shown by screening PCR analysis. DNA hybridization confirmed this inference, detecting blaSHV gene in these isolates. Pulsed-field gel electrophoresis (PFGE) defined one predominant genomic group; group A (seven isolates) and four different genotypes containing one to two isolates. Clonally related isolates were recovered from three patients and from two washbasins. Sequencing DNA of cluster representative strains identified the classical blaSHV-1 gene. For these strains, the nucleotide sequence of the structural blaSHV-1 gene was nearly identical to those previous...
Clinical Microbiology and Infection, 2007
Acta Microbiologica et Immunologica Hungarica, 2021
The purpose of our study was to investigate the epidemiology of coagulase negative staphylococci ... more The purpose of our study was to investigate the epidemiology of coagulase negative staphylococci (CoNS) responsible for bacteremia in hematopoietic stem cell transplant (HSCT) recipients and to determine the prevalence and the genetic background of methicillin resistance. The prevalence of CoNS bacteremia was 7.4% (54/728), higher in allograft (10.7%) than in autograft (4.7%) recipients. A sepsis or a septic shock were observed in 9% of cases. No deaths were attributable to CoNS bacteremia. The methicillin resistance rate was 81%. All MR-CoNS, harbored mecA gene and 90% were typeable with SCCmec typing using PCR amplification. The SCCmec type IV was the most frequent (44%). Clonal dissemination of MR- Staphylococcus epidermidis strains was limited. Our study showed a low prevalence and favorable outcome of CoNS bacteremia in HSCT recipients with limited clonal diffusion. However, they were associated with a significant rate of severe infections and a high rate of methicillin resista...
OBJECTIVE The aim of this study was to determine the overall percentage of beta-lactams susceptib... more OBJECTIVE The aim of this study was to determine the overall percentage of beta-lactams susceptibility, beta-lactamase production, penicillin binding protein (PBP) modification and serotypes of colonizing Haemophilus influenzae strains. DESIGN A total of 50 isolates of colonized H. influenzae, isolated from neutropenic patients. The prevalence of beta-lactams resistance and beta-lactamase production were recorded for each strains using E-test strips and chromogenic cephalosporin test, then were determined their resistance genes (bla(TEM) and bla(ROB)) by PCR as well as their capsular types by standard slide agglutination serotyping (SAST) and capsular genes amplification. RESULTS Thirty-two percent of the 50 strains were amoxicillin resistant, among these, 20% were resistant by beta-lactamase production, and they produced all type TEM beta-lactamase. Four percent of the isolates had PBP modification and three strains (6%) associated the two resistance mechanisms. Slide agglutination...
APMIS, 2014
Neisseria mucosa, a Gram-negative diplococcus, is part of normal nasopharyngeal flora. We report ... more Neisseria mucosa, a Gram-negative diplococcus, is part of normal nasopharyngeal flora. We report a case of bacteremia caused by N. mucosa in a 50-year-old neutropenic patient suffering from non-secretory multiple myeloma stage IIIA. This case underscores that mostly nonpathogenic N. mucosa can cause bacteremia in neutropenic patients who developed mucositis after hematopoietic stem cell transplantation.
Journal of Global Antimicrobial Resistance
Pathologie-biologie, 2009
The aim of this study was to determine the overall percentage of beta-lactams susceptibility, bet... more The aim of this study was to determine the overall percentage of beta-lactams susceptibility, beta-lactamase production, penicillin binding protein (PBP) modification and serotypes of colonizing Haemophilus influenzae strains. A total of 50 isolates of colonized H. influenzae, isolated from neutropenic patients. The prevalence of beta-lactams resistance and beta-lactamase production were recorded for each strains using E-test strips and chromogenic cephalosporin test, then were determined their resistance genes (bla(TEM) and bla(ROB)) by PCR as well as their capsular types by standard slide agglutination serotyping (SAST) and capsular genes amplification. Thirty-two percent of the 50 strains were amoxicillin resistant, among these, 20% were resistant by beta-lactamase production, and they produced all type TEM beta-lactamase. Four percent of the isolates had PBP modification and three strains (6%) associated the two resistance mechanisms. Slide agglutination serotyping showed that 9...
Pathologie-biologie, 2007
Thirteen patients treated with gut decontamination were screened over a period of three years for... more Thirteen patients treated with gut decontamination were screened over a period of three years for digestive colonization and acquisition of resistant strains, in fact 297 strains had been isolated from 226 stool cultures within 120 enterobacteria and other species. Our study pointed out a betaLSE digestive colonization rate of 30.8% of the total enterobacteria isolated, these strains exhibit resistance of most beta-lactams especially against third generation cephalosporins. This analysis showed that these strains are endogen and specific for each patient, the common multiresistance resulted from the selective pressure of gut decontamination.
Bulletin de la Société de pathologie exotique (1990), 2006
In this article a Cytomegalovirus (CMV) antigenemia and semiquantitative PCR retrospective evalua... more In this article a Cytomegalovirus (CMV) antigenemia and semiquantitative PCR retrospective evaluation of 26 bone marrow allo-grafted patients for different haematological disease is reported. Eighteen patients had a CMV reactivation despite a prophylactic treatment, seven of those patients had both positive antigenemia pp65 and positive semi-quantitative CMV PCR. During CMV reactivation, 3 patients developed a CMV disease despite a pre-emptive therapy. The follow up of the antigenemia was performed since D21 until D100 post transplantation, the antigenemia positivity occurred at D53 and was preceded about 7 days by CMV PCR positivity The CMV disease wasn't associated with a high viral load. All patients that had CMV reactivation had a positive CMV serology before the graft, whereas only 37.5% of the patients who did not reactivate had a positive CMV serology. Respectively half patients who reactivated and only 12.5% of those who didn't had a Graft versus host disease (GVHD),...
Médecine et maladies infectieuses, 2005
Our study dealt with antibiotic resistance and serotypes of Pseudomonas aeruginosa strains isolat... more Our study dealt with antibiotic resistance and serotypes of Pseudomonas aeruginosa strains isolated from immunocompromised patients in the National Bone Marrow Transplant Center of Tunis as well as molecular typing of ceftazidime resistant strains (CAZ-R). We studied a total of 87 non-replicate P. aeruginosa isolates from 36 patients (84 strains) or the hospital environment (3 strains). Rates of antimicrobial resistance were 36% for ceftazidime, 16% for imipenem, 38% for amikacin, and 57% for ciprofloxacin. The 31 CAZ-R strains were associated with O:11 serotype in 84% of the cases. Genetically characterization of CAZ-R strains by Pulsed Field Gel Electrophoresis (PFGE) after digestion of genomic DNA with SpeI revealed 2 genotypic groups. The first was composed of strains isolated from one outpatient between November 1998 and April 1999. Resistance phenotypes of these strains varied after use of antimicrobial drugs. The second was predominant (18/31 CAZ-R strains) in both hematology...
![Research paper thumbnail of [Characteristics of Enterococcus strains isolated from neutropenic patients at the National Bone-Marrow Transplantation Center of Tunis]](https://attachments.academia-assets.com/66405623/thumbnails/1.jpg)
](Bulletin de la Société de pathologie exotique (1990), 2004
The frequency of digestive colonization of neutropenic patients by Enterococci during the phase o... more The frequency of digestive colonization of neutropenic patients by Enterococci during the phase of pre-transplant and post-transplant of bone marrow is important indeed as 441 Enterococcus spp strains have been isolated from stool-cultures and other specimens whithin a period of 35 months in 80 patients. A quantitative stool culture was done on appropriate media. Simple bile-esculine agar (BE) and bile esculine-agar additionned with 6 mg/l of vancomycine (BEV) were used for detecting Enterococci. These organisms were taken into account, when then numeration was > 10(3) UFC/g of fecal sample on BE and in all cases on BEV. Species isolated were essentially Enterococcus faecalis (39.4%), Enterococcus faecium (34.4%) and Enterococcus casseliflavus (17%). These strains were characterized by a high frequency of high-level resistance to gentamicin (40.8%). Resistance to amoxicillin concerns 40% of E. faecium strains. Seventeen multiresistant strains of E. faecium isolated from 7 patient...
Annales françaises d'anesthèsie et de rèanimation, 2003
To evaluate infectious complications related to non-tunneled central venous catheter in immunocom... more To evaluate infectious complications related to non-tunneled central venous catheter in immunocompromised patients, in a bone marrow unit. From July to April 2002, we inserted 210 non-tunneled central venous catheters in 139 immunocompromised patients (52 F/87 M). The mean age was 26 years (3-56 years). Our study included 33 children aged from 3 to 15 years, on whom 46 catheters were placed. The catheters were placed for the following indications: 145 catheters were used in subjects who received a bone marrow transplantation, 58 catheters were placed in subjects who received chemotherapy for acute leukemia and seven catheters were used in patients who received immunosuppressive therapy. The mean duration of catheterization was 33 days (7-114 days). There were 3.1 catheter-related infections per 1000 catheter-days. Coagulase-negative Staphylococci were implicated in 64% of cases. We observed two pneumothorax (0.9%), one arterial puncture (0.4%) and two catheter-related thrombosis (0....
AbstractObjectives. – Investigation of the occurrence and antibiotic susceptibility of Enterococc... more AbstractObjectives. – Investigation of the occurrence and antibiotic susceptibility of Enterococcus faecium isolates, collected during four years fromneutropenic patients at the Tunisian bone marrow transplantation centre.Materials and methods. – E. faecium strains were identified by conventional methods and by the Api20 Strep (Bio-Merieux, France). Antibioticsusceptibility was determined by the disk diffusion method on Mueller-Hinton agar and interpreted as recommended by CA-SFM. MICs ofampicillin, vancomycin, and teicoplanin were determined by E-test method.Results. – TwohundredandthirtyfiveE.faeciumisolateswererecoveredfromstoolculturesorrectalswabs(229),throat(three),urine(two),andpus of wound (one). None was responsible for bacteraemia. Ampicillin resistance, without production of b-lactamase, was observed in 43.8% ofisolates. All the isolates were susceptible to glycopeptides. High rates of resistance were observed: high-level resistance (HLR) to gentamicin(33.6%), HLR to kanamy...
Imaging of Spinal Infection, 2021
Salmonella osteomyelitis is uncommon and generally associated with sickle cell disease. Vertebral... more Salmonella osteomyelitis is uncommon and generally associated with sickle cell disease. Vertebral location is extremely rare and has mainly been reported in case reports. Magnetic resonance imaging (MRI) is the modality of choice for assessing discovertebral and soft tissue abnormalities. Imaging features are similar to other spondylodiscitis. Bacteria isolation is necessary for definitive diagnosis and antibiotic susceptibility testing, allowing adequate medical treatment.
L'infection a cytomegalovirus (CMV) represente la complication infectieuse la plus frequente ... more L'infection a cytomegalovirus (CMV) represente la complication infectieuse la plus frequente et la plus redoutable chez les patients greffes de moelle osseuse. Le risque majeur etant represente par la maladie a CMV qui, une fois declaree, est pourvoyeuse d'une morbidite et d'une mortalite elevees, malgre le traitement. Plusieurs techniques sont utilisees pour faire le diagnostic de reactivation afin d'initier le plus precocement possible un traitement antiviral pre-emptif. Toutes ces techniques se basent sur l'evaluation de la charge virale qui represente un marqueur fiable pour le diagnostic d'une reactivation et pour le monitorage du traitement. Apres un rappel sur le CMV, nous presentons dans cette revue les differentes methodes et les techniques utilisees pour le depistage de cette reactivation en degageant leurs avantages et leurs inconvenients.
Multidrug Resistant Bacteremia: Clinical And Bacteriological Epidemiology In Hematopoietic Stem C... more Multidrug Resistant Bacteremia: Clinical And Bacteriological Epidemiology In Hematopoietic Stem Cell Transplant Recipients Mellouli A*1,2, Chebbi Y1,2, Fatmi R EL2,3, Radaoui A1,2, LAKHAL A2,3, Torjemane L2,3, Ben Abeljelil N2,3, Belloumi D2,3, Ladeb S2,3, Ben Othman T2,3, Achour W1,2 1Service Des Laboratoires, Centre National De Greffe De Moelle Osseuse, Tunis, Tunisia 2Faculte De Medecine De Tunis, Universite De Tunis El Manar, LR18ES39, Tunis, Tunisia 3Service D’Hematologie, Centre National De Greffe De Moelle Osseuse, Tunis, Tunisia
Twelve multidrug-resistant Pseudomonas aeruginosa (MDRPA) isolates were recovered over a period o... more Twelve multidrug-resistant Pseudomonas aeruginosa (MDRPA) isolates were recovered over a period of two years in the National Bone Marrow Transplant Centre of Tunisia. MDRPA isolates were isolated from seven patients and from three environmental samples. Isoelectric focusing revealed pIs of 8.2, 5.5 and 7.6 in all MDRPA isolates. These strains produced the OXA-18 extended spectrum b-lactamase and an SHV type b-lactamase as shown by screening PCR analysis. DNA hybridization confirmed this inference, detecting blaSHV gene in these isolates. Pulsed-field gel electrophoresis (PFGE) defined one predominant genomic group; group A (seven isolates) and four different genotypes containing one to two isolates. Clonally related isolates were recovered from three patients and from two washbasins. Sequencing DNA of cluster representative strains identified the classical blaSHV-1 gene. For these strains, the nucleotide sequence of the structural blaSHV-1 gene was nearly identical to those previous...
Clinical Microbiology and Infection, 2007
Acta Microbiologica et Immunologica Hungarica, 2021
The purpose of our study was to investigate the epidemiology of coagulase negative staphylococci ... more The purpose of our study was to investigate the epidemiology of coagulase negative staphylococci (CoNS) responsible for bacteremia in hematopoietic stem cell transplant (HSCT) recipients and to determine the prevalence and the genetic background of methicillin resistance. The prevalence of CoNS bacteremia was 7.4% (54/728), higher in allograft (10.7%) than in autograft (4.7%) recipients. A sepsis or a septic shock were observed in 9% of cases. No deaths were attributable to CoNS bacteremia. The methicillin resistance rate was 81%. All MR-CoNS, harbored mecA gene and 90% were typeable with SCCmec typing using PCR amplification. The SCCmec type IV was the most frequent (44%). Clonal dissemination of MR- Staphylococcus epidermidis strains was limited. Our study showed a low prevalence and favorable outcome of CoNS bacteremia in HSCT recipients with limited clonal diffusion. However, they were associated with a significant rate of severe infections and a high rate of methicillin resista...
OBJECTIVE The aim of this study was to determine the overall percentage of beta-lactams susceptib... more OBJECTIVE The aim of this study was to determine the overall percentage of beta-lactams susceptibility, beta-lactamase production, penicillin binding protein (PBP) modification and serotypes of colonizing Haemophilus influenzae strains. DESIGN A total of 50 isolates of colonized H. influenzae, isolated from neutropenic patients. The prevalence of beta-lactams resistance and beta-lactamase production were recorded for each strains using E-test strips and chromogenic cephalosporin test, then were determined their resistance genes (bla(TEM) and bla(ROB)) by PCR as well as their capsular types by standard slide agglutination serotyping (SAST) and capsular genes amplification. RESULTS Thirty-two percent of the 50 strains were amoxicillin resistant, among these, 20% were resistant by beta-lactamase production, and they produced all type TEM beta-lactamase. Four percent of the isolates had PBP modification and three strains (6%) associated the two resistance mechanisms. Slide agglutination...
APMIS, 2014
Neisseria mucosa, a Gram-negative diplococcus, is part of normal nasopharyngeal flora. We report ... more Neisseria mucosa, a Gram-negative diplococcus, is part of normal nasopharyngeal flora. We report a case of bacteremia caused by N. mucosa in a 50-year-old neutropenic patient suffering from non-secretory multiple myeloma stage IIIA. This case underscores that mostly nonpathogenic N. mucosa can cause bacteremia in neutropenic patients who developed mucositis after hematopoietic stem cell transplantation.
Journal of Global Antimicrobial Resistance
Pathologie-biologie, 2009
The aim of this study was to determine the overall percentage of beta-lactams susceptibility, bet... more The aim of this study was to determine the overall percentage of beta-lactams susceptibility, beta-lactamase production, penicillin binding protein (PBP) modification and serotypes of colonizing Haemophilus influenzae strains. A total of 50 isolates of colonized H. influenzae, isolated from neutropenic patients. The prevalence of beta-lactams resistance and beta-lactamase production were recorded for each strains using E-test strips and chromogenic cephalosporin test, then were determined their resistance genes (bla(TEM) and bla(ROB)) by PCR as well as their capsular types by standard slide agglutination serotyping (SAST) and capsular genes amplification. Thirty-two percent of the 50 strains were amoxicillin resistant, among these, 20% were resistant by beta-lactamase production, and they produced all type TEM beta-lactamase. Four percent of the isolates had PBP modification and three strains (6%) associated the two resistance mechanisms. Slide agglutination serotyping showed that 9...
Pathologie-biologie, 2007
Thirteen patients treated with gut decontamination were screened over a period of three years for... more Thirteen patients treated with gut decontamination were screened over a period of three years for digestive colonization and acquisition of resistant strains, in fact 297 strains had been isolated from 226 stool cultures within 120 enterobacteria and other species. Our study pointed out a betaLSE digestive colonization rate of 30.8% of the total enterobacteria isolated, these strains exhibit resistance of most beta-lactams especially against third generation cephalosporins. This analysis showed that these strains are endogen and specific for each patient, the common multiresistance resulted from the selective pressure of gut decontamination.
Bulletin de la Société de pathologie exotique (1990), 2006
In this article a Cytomegalovirus (CMV) antigenemia and semiquantitative PCR retrospective evalua... more In this article a Cytomegalovirus (CMV) antigenemia and semiquantitative PCR retrospective evaluation of 26 bone marrow allo-grafted patients for different haematological disease is reported. Eighteen patients had a CMV reactivation despite a prophylactic treatment, seven of those patients had both positive antigenemia pp65 and positive semi-quantitative CMV PCR. During CMV reactivation, 3 patients developed a CMV disease despite a pre-emptive therapy. The follow up of the antigenemia was performed since D21 until D100 post transplantation, the antigenemia positivity occurred at D53 and was preceded about 7 days by CMV PCR positivity The CMV disease wasn't associated with a high viral load. All patients that had CMV reactivation had a positive CMV serology before the graft, whereas only 37.5% of the patients who did not reactivate had a positive CMV serology. Respectively half patients who reactivated and only 12.5% of those who didn't had a Graft versus host disease (GVHD),...
Médecine et maladies infectieuses, 2005
Our study dealt with antibiotic resistance and serotypes of Pseudomonas aeruginosa strains isolat... more Our study dealt with antibiotic resistance and serotypes of Pseudomonas aeruginosa strains isolated from immunocompromised patients in the National Bone Marrow Transplant Center of Tunis as well as molecular typing of ceftazidime resistant strains (CAZ-R). We studied a total of 87 non-replicate P. aeruginosa isolates from 36 patients (84 strains) or the hospital environment (3 strains). Rates of antimicrobial resistance were 36% for ceftazidime, 16% for imipenem, 38% for amikacin, and 57% for ciprofloxacin. The 31 CAZ-R strains were associated with O:11 serotype in 84% of the cases. Genetically characterization of CAZ-R strains by Pulsed Field Gel Electrophoresis (PFGE) after digestion of genomic DNA with SpeI revealed 2 genotypic groups. The first was composed of strains isolated from one outpatient between November 1998 and April 1999. Resistance phenotypes of these strains varied after use of antimicrobial drugs. The second was predominant (18/31 CAZ-R strains) in both hematology...
Bulletin de la Société de pathologie exotique (1990), 2004
The frequency of digestive colonization of neutropenic patients by Enterococci during the phase o... more The frequency of digestive colonization of neutropenic patients by Enterococci during the phase of pre-transplant and post-transplant of bone marrow is important indeed as 441 Enterococcus spp strains have been isolated from stool-cultures and other specimens whithin a period of 35 months in 80 patients. A quantitative stool culture was done on appropriate media. Simple bile-esculine agar (BE) and bile esculine-agar additionned with 6 mg/l of vancomycine (BEV) were used for detecting Enterococci. These organisms were taken into account, when then numeration was > 10(3) UFC/g of fecal sample on BE and in all cases on BEV. Species isolated were essentially Enterococcus faecalis (39.4%), Enterococcus faecium (34.4%) and Enterococcus casseliflavus (17%). These strains were characterized by a high frequency of high-level resistance to gentamicin (40.8%). Resistance to amoxicillin concerns 40% of E. faecium strains. Seventeen multiresistant strains of E. faecium isolated from 7 patient...
Annales françaises d'anesthèsie et de rèanimation, 2003
To evaluate infectious complications related to non-tunneled central venous catheter in immunocom... more To evaluate infectious complications related to non-tunneled central venous catheter in immunocompromised patients, in a bone marrow unit. From July to April 2002, we inserted 210 non-tunneled central venous catheters in 139 immunocompromised patients (52 F/87 M). The mean age was 26 years (3-56 years). Our study included 33 children aged from 3 to 15 years, on whom 46 catheters were placed. The catheters were placed for the following indications: 145 catheters were used in subjects who received a bone marrow transplantation, 58 catheters were placed in subjects who received chemotherapy for acute leukemia and seven catheters were used in patients who received immunosuppressive therapy. The mean duration of catheterization was 33 days (7-114 days). There were 3.1 catheter-related infections per 1000 catheter-days. Coagulase-negative Staphylococci were implicated in 64% of cases. We observed two pneumothorax (0.9%), one arterial puncture (0.4%) and two catheter-related thrombosis (0....