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Peripherally inserted central catheter-associated bloodstream infection: Risk factors and the role of

Evgenia Kagan1, Cassandra D Salgado1, Andrea L Banks1

  • 1Division of Infectious Diseases, Medical University of South Carolina, Charleston, SC.

American Journal of Infection Control
|September 6, 2018
PubMed

Insights

Antimicrobial-impregnated peripherally inserted central catheters (PICCs) significantly reduce the risk of central line-associated bloodstream infections (CLABSIs). Non-antimicrobial-impregnated PICCs showed a higher infection risk, especially when placed by interventional radiology.

Area of Science:

  • Infectious Diseases
  • Medical Devices
  • Patient Safety

Background:

  • Central line-associated bloodstream infections (CLABSIs) are a significant concern in healthcare settings.
  • Peripherally inserted central catheters (PICCs) are commonly used, but carry a risk of CLABSI.
  • Antimicrobial-impregnated (AIP) PICCs are designed to reduce infection risk compared to non-antimicrobial-impregnated (NAIP) catheters.

Purpose of the Study:

  • To assess risk factors for CLABSI in patients with PICCs.
  • To specifically evaluate the impact of AIP PICCs on CLABSI rates.
  • To compare CLABSI risks associated with different PICC placement methods and catheter types.

Main Methods:

  • A retrospective study design was used to determine CLABSI rates among patients receiving PICCs between July 2009 and June 2012.
  • A nested case-control study was conducted, matching for operators (interventional radiology, infectious diseases, and venous access team).
  • Risk factors for PICC-related CLABSI were analyzed.

Main Results:

  • Eighty-nine PICC CLABSIs (1.66%) occurred in 5,372 PICC placements.
  • Interventional radiology-placed PICCs had a higher infection risk compared to those placed by infectious diseases or the venous access team.
  • Non-antimicrobial-impregnated (NAIP) catheters placed by interventional radiology showed a 5.45-fold greater CLABSI risk compared to antimicrobial-impregnated (AIP) catheters.

Conclusions:

  • PICC CLABSIs were highest in patients receiving NAIP catheters.
  • Risk factors for CLABSI included chemotherapy, tunneled catheter placement, leukemia, and AIDS.
  • The study recommends considering AIP PICCs for all patients receiving PICCs to mitigate infection risk.
Abstract

Keywords:
Bloodstream infectionCentral line–associated bloodstream infectionPeripherally inserted central catheter

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