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Incidence, complications, and costs of peripheral venous catheter-related bacteraemia: a retrospective, single-centre
B Drugeon1, J Guenezan2, M Pichon3
1CHU de Poitiers, Service des Urgences et SAMU 86, Poitiers, France; Université de Poitiers, INSERM U1070, Pharmacologie des Agents Anti-Infectieux et Résistance (PHAR2), Poitiers, France.
Background:
Peripheral venous catheter (PVC) complications occur on average in approximately half of patients, necessitating premature PVC removal, suspending administration of ongoing therapies, and catheter replacement.
Aim:
To estimate the current incidence, complications, and costs of bloodstream infection (BSI) attributable to PVCs.
Methods:
Patients with PVC-related BSI (cases) were matched with patients without PVC-related BSI (controls).
Findings:
From January 1st, 2018 to March 31st, 2020, a total of 9833 out of 113,068 patients visiting the emergency department (9%) were hospitalized in a medical ward after insertion of a PVC. Among them, 581 (6%) had at least one positive blood culture. Twenty-five (4%) of these were judged as having a PVC-related BSI. Major complications were noted in nine patients. One patient presented severe sepsis requiring admission to intensive care unit for eleven days followed by thoracic (T4-T7) spondylodiscitis requiring prolonged antimicrobial therapy. Another patient developed mitral valve endocarditis also requiring prolonged antimicrobial therapy. One patient developed a pre-sacral abscess three months after initial PVC infection and required hospital readmission for 19 days for drainage. Median (interquartile range) hospital stay costs were €11,597 (8,479-23,759) for cases and €6,789 (4,019-10,764) for controls, leading to median additional costs of €5,587.
Conclusion:
Though the risk of developing PVC-related BSI in patients admitted to medical wards may seem low, complications of PVC-related BSI are severe, and associated mortality remains high. The financial resources used to treat these complications could be better spent on prevention, including the use of high-quality materials and technologies, and improved training of healthcare providers.
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