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Published on: July 13, 2019
Incorporating anti-infective drugs into peripherally inserted catheters does not reduce infection rates in neonates
Julia Koppitz1,2, Rudolf Georg Ascherl1, Ulrich Herbert Thome1
1Neonatologie, Universitätsklinikum Leipzig, Leipzig, Germany.
Insights
Anti-infective drug-impregnated peripherally inserted central venous catheters (PICCs) did not significantly reduce infection rates in neonates compared to standard PICCs. Current antibiotic impregnations may not effectively prevent bloodstream infections in this population.
Area of Science:
- Neonatal Medicine
- Infectious Diseases
- Medical Devices
Background:
- Peripherally inserted central venous catheters (PICCs) are crucial for neonatal care.
- Catheter-related bloodstream infections (CRBSI) pose a significant risk to neonates.
Purpose of the Study:
- To evaluate if anti-infective drug-impregnated PICCs (A-PICC) reduce infection rates in neonates compared to standard PICCs (S-PICC).
Main Methods:
- Retrospective analysis of electronic patient records for neonates with PICCs (August 2014 - May 2020).
- Infection diagnosis based on clinical symptoms, lab results, and medical records.
- Analysis of dwell time, mechanical ventilation, insertion site, CRP, and drug use.
Main Results:
- No significant difference in infection rates between A-PICC (18.9%) and S-PICC (12.5%) groups (p=0.257).
- A-PICCs had significantly longer dwell times (median 372 vs. 219 hours, p=0.004).
- No significant differences in time to infection, CRP, insertion site issues, or anti-infective drug use.
Conclusions:
- This study found no significant reduction in neonatal infection rates with anti-infective impregnated PICCs.
- Current antibiotic impregnation strategies may not be effective in preventing CRBSI in neonates.
Purpose:
This study assesses whether peripherally inserted central venous catheters (PICC), impregnated with anti-infective drugs, reduce the rate of infections in neonates compared with unimpregnated catheters.
Methods:
A retrospective analysis was conducted on electronic patient records of neonates born between August 2014 and May 2020, who had PICCs inserted, either standard (S-PICC) or with anti-infective drugs (A-PICC). Catheter-related bloodstream infections (CRBSI) were diagnosed based on clinical symptoms, laboratory results, and mentioning of infection in the patient record. Data on dwell time, mechanical ventilation, insertion site, maximum C-reactive protein (CRP) concentration, and anti-infective drug use were analyzed.
Results:
A total of 223 PICCs were included. The infection rates were A-PICC (18.9%) and S-PICC (12.5%), which were not significantly different (p = 0.257). A-PICCs had significantly longer dwell times than S-PICCs (median 372 vs. 219 h, p = 0.004). The time to infection was not different between the groups (p = 0.3). There were also no significant differences in maximum CRP, insertion site abnormalities, or anti-infective drug use between the groups.
Conclusion:
This retrospective study did not find a significant reduction in infection rates by using PICCs containing anti-infective drugs in neonates. Current antibiotic impregnations do not seem to be effective in preventing blood stream infections.
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