Epidural Catheter- and Port-Related Infections in Pain Medicine: A Cohort Study from a Chronic Pain Center with Long-Term Catheterization

Epidural catheters and epidural port systems are widely used in interventional pain management; however, infectious complications remain an important safety concern, particularly during prolonged catheterization. This retrospective real-world cohort study evaluated the incidence, microbiological characteristics, and time-dependent risk factors of epidural catheter- and port-related infections in a tertiary pain clinic. A total of 352 patients were included after predefined exclusion criteria were applied. Infection was defined based on clinical findings and microbiological confirmation. The overall infection rate was 10.5% (37/352). Catheter duration was significantly longer in patients who developed infection and remained an independent predictor in multivariable logistic regression analysis (odds ratio per day: 1.12; 95% CI: 1.06–1.19; p = 0.002). Receiver operating characteristic analysis demonstrated moderate discriminatory ability of catheter duration for predicting infection (AUC = 0.68), with an optimal cut-off of 7 days. The most frequently isolated pathogens were methicillin-resistant coagulase-negative staphylococci. No cases of meningitis or sepsis occurred, and all infections were successfully managed with antibiotic therapy. These findings emphasize the importance of duration-based risk assessment and careful follow-up strategies in patients requiring prolonged epidural analgesia.