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"Greater PVC size may increase the risk of PVC-associated BSI. Diameter size should be considered when selecting PVCs to reduce the burden of PVC-associated BSI" Faltoni et al (2023).

Abstract:

Abstract:

Objectives: Short-term peripheral venous catheter associated bloodstream infections (PVC-associated BSI) are disregarded in the literature due to their relatively low incidence. No data are available on the association between PVC diameter size and the risk of PVC-associated BSI.

Methods: Using a prospective database, we performed an observational study at the University of Geneva Hospitals from 1 January 2020 to 31 December 2021, including all patients with a PVC. We used univariable and multivariable marginal Cox regression models for clustered data to investigate the association between catheter size and PVC-associated BSI. The main variable of interest “catheter size” was forced into our multivariable models. Confounders, which are thought to influence the risk of PVC-associated BSI, were used as adjustment factors.

Results: A total of 206,804 PVCs were included. 10,806/201,413 (5.4%), 80,274/201,413 (39.9%), 93,047/201,413 (46.2%) and 17,286/201,413 (8.6%) PVCs measured ≤16G, 18G, 20G and ≥22G, respectively. The univariable analysis showed that diameters of ≤16G were significantly associated to a higher risk of PVC-associated BSI (hazard ratio [HR] 4.52, 95% CI, 1.14-18.00). Multivariable models confirmed these results (HR 4.65, 95% CI, 1.19-18.20). Sensitivity analyses including PVC inserted only in 2021 (HR 4.80, 95% CI, 1.21-19.10), for dwell-time >2 days (HR 3.67 95% CI, 0.92-14.65) and only in adults (HR 3.97, 95% CI, 0.97-15.39) showed similar results.

Conclusions: Greater PVC size may increase the risk of PVC-associated BSI. Diameter size should be considered when selecting PVCs to reduce the burden of PVC-associated BSI.


Reference:

Faltoni M, Catho G, Pianca E, Minka-Obama B, Zanella MC, Chraiti MN, Fortchantre L, Harbarth S, Buetti N. Catheter size and risk of short-term peripheral venous catheter associated bloodstream infections: an observational study. Clin Microbiol Infect. 2023 Dec 22:S1198-743X(23)00626-2. doi: 10.1016/j.cmi.2023.12.018. Epub ahead of print. PMID: 38142893.