PICC-associated bloodstream infections: prevalence, patterns, and predictors

Area of Science:

• Medical Devices
• Infectious Diseases
• Patient Safety

Background:

• Peripherally inserted central catheters (PICCs) are increasingly used, raising concerns about PICC-associated bloodstream infections (PABCSI).
• Identifying risk factors is crucial for preventing PABCSI.

Purpose of the Study:

• To determine the rates and patterns of PABCSI.
• To identify patient, provider, and device characteristics associated with PABCSI.

Main Methods:

• Retrospective cohort study of adult patients undergoing PICC placement between June 2009 and July 2012.
• Multivariable logistic and Cox-proportional hazards regression models were used to analyze associations with PABCSI.
• Odds ratios (OR) and hazard ratios (HR) with 95% confidence intervals (CI) quantified the risk.

Main Results:

• A total of 966 PICCs were inserted in 747 patients over 26,887 catheter days.
• Bivariate analysis showed ICU status, mechanical ventilation, length of stay, PowerPICCs, and interventional radiology placement were associated with PABCSI.
• Catheter lumens (double and triple) showed strong associations with PABCSI.
• Multivariable analysis identified hospital length of stay, ICU status, and number of PICC lumens as significant predictors of PABCSI.
• Multi-lumen PICCs were associated with an earlier time to infection.

Conclusions:

• Hospital length of stay, ICU status, and the number of PICC lumens are key factors associated with PABCSI.
• Implementing targeted policies and procedures focusing on these factors may help reduce the incidence of PABCSI.