Effect of using standard versus antimicrobial-impregnated neonatal peripherally inserted central catheters in preterm...

The aim of this study was to evaluate the effectiveness of the use of antimicrobial-impregnated neonatal peripherally inserted central catheters (AI n-PICC) compared to the use of standard n-PICC (S n-PICC).

The study was planned as prospective randomized controlled trial (open-label). Babies with a birth weight of less than 1500 g in a 4-year period were included in the study. Newborns who needed a n-PICC were allocated randomly (1:1) to receive either an AI n-PICC (impregnated with miconazole and rifampicin) or a S n-PICC. The primary outcome was the incidence of central line-associated bloodstream infection (CLABSI), and secondarily, to assess reasons for catheter removal, and catheter duration times in these two groups.

There were a total of 254 infants from both groups during the study. The mean gestational age were 27.6 ± 2.8 week in S group and 27.5 ± 2.8 week in AI group. No significant differences observed in gestational age, birth weight, enteral feeding parameters, hospital stay, or antibiotic use duration (p > 0.05). The mean dwelling time was 14.2 ± 8.5 day in S group and 15.4 ± 9.7 day in AI group (p:0.293). The frequency of catheter withdrawal due to complications were 29.9% in the S group and 19.7% in the AI group (p:0.081). CLABSI rate (per 1000 catheter days) were found 9.44 in S group and 3.07 in AI group (p:0.013). The use of AI n-PICCs were associated with a 74% reduction in the hazard of catheter-related infection (HR = 0.26, 95% CI [0.09, 0.70], p = 0.008).

Our study demonstrates that the use of AI n-PICCs was associated with a reduction in the rate of infection development in premature infants requiring n-PICC. The use of AI n-PICC may be effective especially in premature infants with a high risk of developing catheter-related infection.