Novel factors identified relating to peripherally inserted central catheter (PICC) blood stream infection

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Intravenous literature: Pongruangporn, M., Ajenjo, C., Russo, A.J., McMullen, K.M., Robinson, C., Williams, R.C. and Warren, D.K. (2013) Patient- and Device-Specific Risk Factors for Peripherally Inserted Central Venous Catheter–Related Bloodstream Infections. Infection Control and Hospital Epidemiology. 34(2), p.184-189.

Abstract:

Objective: To determine the patient- and device-specific risk factors for hospital-acquired peripherally inserted central venous catheter–related bloodstream infections (PICC BSIs) in adult patients.

Design: Nested case-control study. Setting.?Barnes-Jewish Hospital, a 1,252-bed tertiary care teaching hospital.

Patients: Adult patients with PICCs placed from January 1, 2006, through July 31, 2008.

Methods: PICC BSI cases were identified using the National Healthcare Safety Network definition. Uninfected control patients with PICCs in place were randomly selected at a 3?1 ratio. Patient- and device-related variables were examined using multivariate analysis.

Results: The overall PICC BSI rate was 3.13 per 1,000 catheter-days. Independent risk factors for PICC BSIs included congestive heart failure (odds ratio [OR], 2.0 [95% confidence interval (CI), 1.26–3.17]; ), intra-abdominal perforation (OR, 5.66 [95% CI, 1.76–18.19]; ), Clostidium difficile infection (OR, 2.25 [95% CI, 1.17–4.33]; ), recent chemotherapy (OR, 3.36 [95% CI, 1.15–9.78]; ), presence of tracheostomy (OR, 5.88 [95% CI, 2.99–11.55]; ), and type of catheter (OR for double lumen, 1.89 [95% CI, 1.15–3.10]; ; OR for triple lumen, 2.87 [95% CI, 1.39–5.92]; ). Underlying chronic obstructive pulmonary disease (OR, 0.48 [95% CI, 0.29–0.78]; ) and admission to surgical (OR, 0.43 [95% CI, 0.24–0.79]; ) or oncology and orthopedic (OR, 0.35 [95% CI, 0.13–0.99]; ) services were less likely to be associated with having a PICC BSI.

Conclusions: We identified several novel factors related to PICC BSIs. These factors may inform preventive measures.

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