Careful assessment required to prevent PICC related infection

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Reference:

Bouzad, C., Duron, S., Bousquet, A., Arnaud, F.X., Valbousquet, L., Weber-Donat, G., Teriitehau, C., Baccialone, J. and Potet, J. (2015) Peripherally Inserted Central Catheter-Related Infections in a Cohort of Hospitalized Adult Patients. Cardiovascular and Interventional Radiology. July 23rd. .

Abstract:

PURPOSE: To determine the incidence and the risks factors of peripherally inserted central catheter (PICC)-related infectious complications.

MATERIALS AND METHODS: Medical charts of every in-patient that underwent a PICC insertion in our hospital between January 2010 and October 2013 were reviewed. All PICC-related infections were recorded and categorized as catheter-related bloodstream infections (CR-BSI), exit-site infections, and septic thrombophlebitis.

RESULTS: Nine hundred and twenty-three PICCs were placed in 644 unique patients, mostly male (68.3 %) with a median age of 58 years. 31 (3.4 %) PICC-related infections occurred during the study period corresponding to an infection rate of 1.64 per 1000 catheter-days. We observed 27 (87.1 %) CR-BSI, corresponding to a rate of 1.43 per 1000 catheter-days, 3 (9.7 %) septic thrombophlebitis, and 1 (3.2 %) exit-site infection. Multivariate logistic regression analysis showed a higher PICC-related infection rate with chemotherapy (odds ratio (OR) 7.2-confidence interval (CI) 95 % [1.77-29.5]), auto/allograft (OR 5.9-CI 95 % [1.2-29.2]), and anti-coagulant therapy (OR 2.2-95 % [1.4-12]).

CONCLUSION: Chemotherapy, auto/allograft, and anti-coagulant therapy are associated with an increased risk of developing PICC-related infections.

CLINICAL ADVANCE: Chemotherapy, auto/allograft, and anti-coagulant therapy are important predictors of PICC-associated infections. A careful assessment of these risk factors may be important for future success in preventing PICC-related infections.

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