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The microbiological characteristics and risk factors for PICC-related bloodstream infections in intensive care unit
Shumin Zhang1, Xiaofeng Sun2, Yan Lei3
1Department of Intensive Care Unit, 306th Hospital of Chinese PLA, Beijing, 100101, China.
Abstract:
The study was aimed to investigate the pathogens distribution and risk factors for PICC-related bloodstream infection in intensive care unit (ICU) patients. 402 patients placed with PICC in ICU were recruited in the study. The microbiological characteristics of PICC-related infection were investigated by Vitek 2 Compact automated microbial system. Antibiotics sensitivity was performed with disk diffusion and minimum inhibitory concentration (MIC) methods. Multivariate logistic and cox analyses were performed to identify the risk factors for PICC-related infection in ICU patients. 38 PICC-related infection cases were observed, and its morbidity was 9.45%. The morbidity was significantly higher in power PICC cases than that in common PICC cases. Gram-positive bacteria might be responsible for the major infection cases, followed by gram-negative bacteria, and fungi. Drug sensitivity analyses indicated that gram-negative bacteria showed low resistance to carbapenems antibiotics, and Cefperazone/sulbactam. The gram-positive bacterial exhibited sensitive to Teicoplanin and Vancomycin. The isolated fungi showed low resistance to the commonly used antifungal antibiotics. Multivariate analyses demonstrated that power PICC, high Charison scores, diabetes mellitus, double lumens triple lumens were risk factors for PICC-related infections among ICU patients. Power PICC, high Charison scores, diabetes mellitus, multi-lumens are risk factors for PICC-related bloodstream infection in ICU patients.
Insights
The study identified key risk factors for bloodstream infections associated with peripherally inserted central catheters (PICCs) in intensive care units (ICUs). Power PICCs and diabetes mellitus were significant risk factors, highlighting areas for infection control improvement.
Area of Science:
- Infectious Diseases
- Critical Care Medicine
- Medical Microbiology
Background:
- Peripherally inserted central catheters (PICCs) are crucial for long-term venous access in intensive care units (ICUs).
- PICC-related bloodstream infections (BSI) pose a significant threat to patient safety and increase healthcare costs.
- Understanding pathogen distribution and risk factors is essential for effective prevention strategies.
Purpose of the Study:
- To investigate the distribution of pathogens causing PICC-related bloodstream infections in ICU patients.
- To identify and analyze the risk factors associated with PICC-related infections in this vulnerable population.
Main Methods:
- A prospective study involving 402 ICU patients with PICCs.
- Microbiological analysis using Vitek 2 Compact automated system for pathogen identification.
- Antibiotic sensitivity testing via disk diffusion and minimum inhibitory concentration (MIC) methods.
- Multivariate logistic and Cox regression analyses to determine risk factors.
Main Results:
- A total of 38 PICC-related infections were observed, with a morbidity rate of 9.45%.
- Power PICCs showed significantly higher infection rates compared to common PICCs.
- Gram-positive bacteria were the predominant pathogens, followed by Gram-negative bacteria and fungi.
- Gram-negative bacteria exhibited low resistance to carbapenems and Cefperazone/sulbactam; Gram-positive bacteria were sensitive to Teicoplanin and Vancomycin.
- Identified risk factors included power PICCs, high Charlson scores, diabetes mellitus, and multi-lumen catheters.
Conclusions:
- Power PICCs, high Charlson scores, diabetes mellitus, and multi-lumen catheters are significant risk factors for PICC-related bloodstream infections in ICU patients.
- Effective infection control measures targeting these risk factors are crucial for reducing PICC-BSI incidence in ICUs.
- Knowledge of local pathogen prevalence and antibiotic susceptibility guides empirical treatment choices.
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