Pocket infections, defined as the spread of infection into the subcutaneous pocket of a totally implanted intravascular device,112 are considered an absolute reason for device removal because of the poor response to antimicrobial therapy by bacteria inside the biofilms on the port inner surface.112,234 Pocket infections remain among the most difficult infectious complications associated with implanted ports. Evidence from studies of intravascular cardiac device infections suggests that risk of local device infections, including pocket infections, in these devices is increasing at a faster rate than the corresponding increase in device implantations.

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