Peripherally inserted central venous catheters decrease central line-associated bloodstream infections and change...

Area of Science:

• Infectious Diseases
• Hematology
• Medical Devices

Background:

• Central line-associated bloodstream infections (CLABSI) are a significant concern in hematology patients.
• The comparative efficacy of peripherally inserted central venous catheters (PICCs) versus centrally inserted central venous catheters (CICCs) in preventing CLABSI in this population requires further investigation due to limited evidence.

Purpose of the Study:

• To compare the risk of CLABSI between PICCs and CICCs in adult patients with hematological disorders.
• To evaluate the superiority of PICCs over CICCs in reducing CLABSI incidence within an adult hematology unit.

Main Methods:

• A single-center retrospective study involving 472 CICCs and 557 PICCs.
• Multivariate Cox regression, Fine-Gray subdistribution analysis, and stabilized inverse probability of treatment weighting (IPTW) were employed.
• Microbiological data was analyzed to identify shifts in causative pathogens.

Main Results:

• Overall CLABSI incidence was lower with PICCs (3.29 per 1000 catheter days) compared to CICCs (5.11 per 1000 catheter days) (P=0.024).
• PICC use was independently associated with a reduced risk of CLABSI across all analytical models (HR 0.48-0.59; P<0.05).
• PICCs demonstrated a decrease in gram-positive cocci (Staphylococci) and an increase in gram-positive bacilli (Corynebacterium species).

Conclusions:

• Peripherally inserted central venous catheters (PICCs) are a superior alternative to centrally inserted central venous catheters (CICCs) for preventing CLABSI in adult hematology patients.
• The use of PICCs is associated with a significant reduction in CLABSI risk.
• A shift in the microbiological profile of CLABSI, with fewer Staphylococci and more Corynebacterium species, was observed with PICC use.