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Catheter size and risk of short-term peripheral venous catheter-associated bloodstream infections: an observational
Matteo Faltoni1, Gaud Catho2, Eva Pianca3
1Infection Control Program and WHO Collaborating Centre, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland; Department of Infectious Diseases, Azienda Ospedaliero-Universitaria of Modena, 41124 Modena, Italy.
Objectives:
Short-term peripheral venous catheter-associated bloodstream infections (PVC-associated BSI) are disregarded in the literature because of their relatively low incidence. No data are available on the association between PVC diameter size and the risk of PVC-associated BSI.
Methods:
Using a prospective database, we performed an observational study at the University of Geneva Hospitals from 1 January 2020 to 31 December 2021, including all patients with a PVC. We used univariable and multivariable marginal Cox regression models for clustered data to investigate the association between catheter size and PVC-associated BSI. The main variable of interest 'catheter size' was forced into our multivariable models. Confounders, which are thought to influence the risk of PVC-associated BSI, were used as adjustment factors.
Results:
A total of 206 804 PVCs were included. In all, 10 806 of 201 413 (5.4%), 80 274 of 201 413 (39.9%), 93 047 of 201 413 (46.2%) and 17 286 of 201 413 (8.6%) PVCs measured ≤16G, 18G, 20G and ≥22G, respectively. The univariable analysis showed that diameters of ≤16G were significantly associated with a higher risk of PVC-associated BSI (hazard ratio [HR] 4.52, 95% CI, 1.14-18.00). Multivariable models confirmed these results (HR 4.65, 95% CI, 1.19-18.20). Sensitivity analyses including PVC inserted only in 2021 (HR 4.80, 95% CI, 1.21-19.10), for dwell time >2 days (HR 3.67, 95% CI, 0.92-14.65) and only in adults (HR 3.97, 95% CI, 0.97-15.39) showed similar results.
Discussion:
Larger PVC size may increase the risk of PVC-associated BSI. Diameter size should be considered when selecting PVCs to reduce the burden of PVC-associated BSI.
Insights
Larger peripheral venous catheters (PVCs) are linked to a higher risk of bloodstream infections (BSI). Choosing smaller diameter PVCs may help reduce PVC-associated BSI incidence.
Area of Science:
- Infectious Diseases
- Medical Devices
- Epidemiology
Background:
- Short-term peripheral venous catheter-associated bloodstream infections (PVC-associated BSI) are often overlooked due to low incidence.
- Limited data exists on the relationship between PVC diameter and BSI risk.
Purpose of the Study:
- To investigate the association between peripheral venous catheter (PVC) diameter size and the risk of PVC-associated bloodstream infections (BSI).
Main Methods:
- Prospective observational study conducted at University of Geneva Hospitals (2020-2021).
- Included over 200,000 peripheral venous catheters (PVCs).
- Utilized univariable and multivariable Cox regression models to analyze catheter size and BSI risk, controlling for confounders.
Main Results:
- Catheters with larger diameters (≤16G) were significantly associated with a higher risk of PVC-associated BSI (adjusted HR 4.65).
- Sensitivity analyses confirmed this association across different scenarios, including dwell time and patient population.
- Over 5% of PVCs were ≤16G, with a notable incidence of BSI.
Conclusions:
- Peripheral venous catheter (PVC) diameter size is a significant factor in the risk of developing PVC-associated bloodstream infections (BSI).
- Consideration of PVC diameter during selection may be crucial for reducing the overall burden of PVC-associated BSI.
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