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Early use of peripherally inserted central catheters is safe in Staphylococcus aureus bacteraemia

James D Stewart1, Naomi Runnegar1,2

  • 1Infection Management Services, Princess Alexandra Hospital, Brisbane, Queensland, Australia.

Internal Medicine Journal
|September 5, 2017
PubMed

Insights

Early insertion of peripherally inserted central catheters (PICCs) for Staphylococcus aureus bacteraemia (SAB) appears safe. This retrospective audit found no increased risk of mortality, infection, or relapse, supporting early PICC placement for reliable intravenous access.

Area of Science:

  • Infectious Diseases
  • Medical Devices
  • Clinical Audits

Background:

  • Management of Staphylococcus aureus bacteraemia (SAB) often involves prolonged intravenous antibiotics.
  • Peripherally inserted central catheters (PICCs) are commonly used for long-term antibiotic administration in SAB.
  • The optimal timing for PICC insertion in SAB patients remains uncertain, with concerns about potential line infections with early placement.

Purpose of the Study:

  • To evaluate the safety and impact of early peripherally inserted central catheter (PICC) insertion in patients with Staphylococcus aureus bacteraemia (SAB).
  • To compare outcomes between early and late PICC insertion groups, focusing on mortality, PICC line infections, duration of bacteraemia, and relapsed SAB.

Main Methods:

  • A retrospective audit was conducted on patients diagnosed with SAB between March 2013 and September 2016.
  • Early PICC insertion was defined as placement within 48 hours of the initial positive blood culture.
  • Outcomes analyzed included crude and attributable mortality, confirmed PICC infections, duration of bacteraemia, and SAB relapse rates.

Main Results:

  • The study included 357 patients with SAB who received a PICC.
  • No significant differences were observed in attributable mortality (6.3% vs. 4.8%), duration of bacteraemia (median 2 days), or relapsed SAB (4.7% vs. 4.1%) between early and late PICC insertion groups.
  • Crucially, no confirmed PICC line infections were identified in either group.

Conclusions:

  • Early peripherally inserted central catheter (PICC) insertion in Staphylococcus aureus bacteraemia (SAB) patients appears to be safe based on this retrospective audit.
  • The findings suggest that early PICC placement does not increase the risk of adverse outcomes such as mortality, infection, or relapse.
  • Further validation through prospective studies is recommended to support the early establishment of reliable intravenous access for SAB patients.
Abstract

Keywords:
Staphylococcus aureusStaphylococcal infectionsbacteraemiacatheter-related infectionsperipherally inserted central catheter line insertion

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