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Does the antimicrobial-impregnated peripherally inserted central catheter decrease the CLABSI rate in neonates?

Mohammad A A Bayoumi1, Matheus F P T van Rens1, Prem Chandra2

  • 1Neonatal Intensive Care Unit (NICU), Women's Wellness and Research Center (WWRC), Hamad Medical Corporation (HMC), Doha, Qatar.

Frontiers in Pediatrics
|December 12, 2022
PubMed
Summary
This summary is machine-generated.

Antimicrobial-impregnated peripherally inserted central catheters (PICCs) did not reduce central line-associated bloodstream infections (CLABSI) in neonates. However, these antimicrobial PICCs showed fewer complications like occlusion and phlebitis compared to conventional PICCs.

Keywords:
antimicrobial-impregnated central venous catheterscentral line-associated bloodstream infectionneonatal intensive care unitneonatenewbornperipherally inserted central cathetervascular accessvascular access devices

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Area of Science:

  • Neonatal Medicine
  • Infectious Diseases
  • Medical Devices

Background:

  • Antimicrobial-impregnated peripherally inserted central catheters (PICCs) were introduced in neonatal units to decrease central line-associated bloodstream infections (CLABSI).
  • This study retrospectively evaluated the efficacy and safety of antimicrobial-impregnated PICCs versus conventional PICCs in neonates.

Purpose of the Study:

  • To compare CLABSI rates between antimicrobial-impregnated and conventional PICCs in a neonatal intensive care unit (NICU).
  • To assess other catheter-related parameters, including insertion success and complication rates.

Main Methods:

  • A retrospective observational study was conducted between 2017 and 2020.
  • Data from 1,242 conventional PICCs and 791 antimicrobial-impregnated PICCs inserted in neonates were analyzed.
  • CLABSI rates, insertion success rates, and catheter-related complications were compared between the two groups.

Main Results:

  • The use of antimicrobial-impregnated PICCs did not result in a significant reduction in overall or yearly CLABSI rates compared to conventional PICCs.
  • The overall PICC insertion success rate was 89.3%, with a first-attempt success rate of 63.5%.
  • Antimicrobial-impregnated PICCs had a higher rate of elective removal post-therapy and fewer instances of extravasation/infiltration, occlusion, and phlebitis.

Conclusions:

  • Miconazole and rifampicin-impregnated PICCs did not lower CLABSI rates in neonates compared to conventional PICCs.
  • Antimicrobial-impregnated PICCs demonstrated a better safety profile regarding specific catheter-related complications.
  • Further large randomized controlled trials (RCTs) are recommended, and exploration of other antimicrobial impregnations for neonatal PICCs is suggested.