“Subcutaneous ports are frequently implanted for patients requiring long term central venous access for infusion of medications, chemotherapy, or total parental nutrition. The most common indication for port placement in the pediatric population is for delivery of chemotherapy, and a significant fraction of these children have neutropenia associated with their cancer diagnosis. While often a marker of immunosuppression, there are conflicting
studies in the literature regarding the relationship between absolute neutrophil count (ANC), as well as other preoperative factors, and port infection, with some reporting no association and others showing increased complications with preoperative neutropenia. These studies vary significantly in cohort size, the provision of antibiotics, and diagnoses included. This lack of consensus and weak evidence regarding risk factors for port infection was highlighted in a recent meta-analysis by the American Pediatric Surgical Association Cancer Committee, which emphasized the need for further investigation.”

“In this study of pediatric venous access port placement, severe neutropenia (defined as absolute neutrophil count less than 500 cells/mm3) and systemic steroid use within 72 h prior to surgery were found to be associated with increased likelihood of port infection within 30 days of placement. These relationships were significant on both univariate analysis and on multivariable regression after adjusting for potential confounding variables. This increased odds of infection in severely neutropenic patients was seen in the cohort overall and driven primarily by the liquid malignancy subgroup whereas the infection risk associated with steroid use was largely due to differences in the solid malignancy subgroup. Steroid use, but not neutropenia, was significantly associated with port removal. Given the retrospective nature of this study, the precise mechanisms driving these diagnosis-based
subgroup differences cannot be definitively determined. These discrepancies may stem from differences in underlying biology of the malignancies themselves, varied indications for steroid use within pediatric oncologic treatment regimens, or other unmeasured clinical factors.”

Katz, Olivia L et al. “Revisiting the association of preoperative steroids, severe neutropenia, and prophylactic antibiotics on pediatric port infections.” Journal of pediatric surgery, 163382. 12 Aug. 2026 Full Text for Emory Users