Catheter-related bloodstream infection associated with multiple insertions of the peripherally inserted central catheter in patients with hematological disorders

Hashimoto, Yoshinori; Hosoda, Rina; Omura, Hiromi; Tanaka, Takayuki

doi:10.1038/s41598-021-91749-4

Cited by 9 publications

(9 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Thus, it is not surprising that patients with haematological malignancies undergoing therapy are inherently at an increased risk of infection. Among haematological malignancies, acute leukaemia had been shown to be associated with higher infection rates ( 19 ). Notably, approximately half of our patients were diagnosed with underlying acute leukaemia and were undergoing treatment.…”

Section: Discussionmentioning

confidence: 99%

Peripherally Inserted Central Venous Catheter-Related Complications in Adult Patients with Haematological Malignancy

Kee Wei,

Chin Sum,

Gin Gin

2024

MJMS

View full text Add to dashboard Cite

Background: Peripherally inserted central venous catheters (PICC) are widely used in patients with haematological malignancies owing to the requirement for prolonged intravenous therapy. However, the growing use of PICCs has resulted in a multitude of complications such as infections and thrombosis, leading to prolonged hospitalisation periods and increased morbidity. This study aimed to determine the incidence of and factors associated with PICC-related complications in patients with haematological malignancies. Methods: This prospective cohort study was conducted at a single academic institution. The inclusion criteria involved all adult patients with haematological malignancies who had newly inserted PICCs. The patients were observed for a minimum duration of 60 days to evaluate the incidence of PICC-related infections and thrombosis, as well as mechanical complications. Results: A total of 119 PICCs were implanted in 85 patients. Among them, more than half of the patients were diagnosed with lymphoma (55.0%). The median dwell time was 61 days (interquartile range: 98 days). The incidence of PICC-related complications was 58.0% (6.9 per 1,000 catheter-days). Specifically, 43 PICCs (36.1%, 4.3 per 1,000 catheter-days) experienced infective complications, 25 (21.1%, 2.5 per 1,000 catheter-days) encountered mechanical complications and 1 (0.8%, 0.1 per 1,000 catheter-days) exhibited thrombotic complications. Furthermore, an underlying diagnosis of acute leukaemia was significantly associated with a higher incidence of PICC-related infections. Conclusion: Our study revealed higher incidence rates of PICC-related complications in adult patients with haematological malignancies compared to the finding of other studies. Notably, patients with underlying acute leukaemia displayed a higher incidence of PICC-related infections. These findings underscore the importance of implementing appropriate interventions and conducting thorough root cause analyses to effectively mitigate this complication and improve patient outcomes.

show abstract

Section: Discussionmentioning

confidence: 99%

Peripherally Inserted Central Venous Catheter-Related Complications in Adult Patients with Haematological Malignancy

Kee Wei,

Chin Sum,

Gin Gin

2024

MJMS

View full text Add to dashboard Cite

show abstract

“…The incidence rates of PICCR-BSI reported in the literature range widely, from 1.0 to 2.1 per 1000 catheter days in noncancer patients [ 23 , 24 ] and from 2.0 to 4.0 per 1000 catheter days in patients with hematological malignancies [ 20 , 21 , 22 ] or solid tumors [ 8 ]. We found that the incidence rate of PICCR-BSI was twice as high in cancer patients treated with chemotherapy as in noncancer patients, which is consistent with previous reports [ 8 , 20 , 21 , 22 , 23 , 24 ]. Among cancer patients, those with hematological malignancies, especially those with leukemia or high-grade lymphoma, are at higher risk for PICCRI compared with patients with solid tumors [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

“…The cancer patient remains fragile and susceptible to infections; therefore, maximum precautions should be taken to limit PICCRI. It seems also important to limit the catheter dwell time [ 9 ], particularly in patients with hematological malignancies [ 20 ]. Although this risk factor remains debated [ 22 ], many studies [ 1 , 20 , 29 ] encouraged clinicians to limit the PICC indwelling time to approximately 4 weeks.…”

Section: Discussionmentioning

confidence: 99%

“…The complication rate appears to be higher in cancer patients than in noncancer patients, especially with regard to the PICC thrombosis rate [ 16 , 17 ]. In the literature, the incidence rates of PICCR-BSI in cancer patients range between 2 and 4 per 1000 catheter days [ 18 , 19 , 20 , 21 , 22 ] and between 1 and 2 per 1000 catheter days in noncancer patients [ 23 , 24 ], but few studies have compared the incidence rate of PICCR-BSI in cancer patients treated with chemotherapy and in noncancer patients.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Peripherally Inserted Central Venous Catheter (PICC) Related Bloodstream Infection in Cancer Patients Treated with Chemotherapy Compared with Noncancer Patients: A Propensity-Score-Matched Analysis

Larcher

Barrigah-Benissan

Ory

et al. 2023

Cancers

View full text Add to dashboard Cite

The use of peripherally inserted central catheters (PICCs) has increased in cancer patients. This study aimed to compare the incidence of PICC-related bloodstream infections (PICCR-BSIs) in cancer patients treated with chemotherapy and in noncancer patients. We performed a secondary analysis from a retrospective, single-center, observational cohort. The PICCR-BSI incidence rates in cancer and noncancer patients were compared after 1:1 propensity-score matching. Then, the factors associated with PICCR-BSI were assessed in a Cox model. Among the 721 PICCs (627 patients) included in the analysis, 240 were placed in cancer patients for chemotherapy and 481 in noncancer patients. After propensity-score matching, the PICCR-BSI incidence rate was 2.6 per 1000 catheter days in cancer patients and 1.0 per 1000 catheter days in noncancer patients (p < 0.05). However, after adjusting for variables resulting in an imbalance between groups after propensity-score matching, only the number of PICC lumens was independently associated with PICCR-BSI (adjusted hazard ratio 1.81, 95% confidence interval: 1.01–3.22; p = 0.04). In conclusion, the incidence rate of PICCR-BSI is higher in cancer patients treated with chemotherapy than in noncancer patients, but our results also highlight the importance of limiting the number of PICC lumens in such patients.

show abstract

“…CRDTV rate observed is not higher than other catheter types. 23 The higher risk recognized in current literature 1 depends on various factors. The new materials, insertion techniques, and the attention to the position of the tip may have contributed to the observed risk reduction.…”

Section: Discussionmentioning

confidence: 99%

Femorally inserted central catheters with exit site at mid-thigh: A low risk alternative for central venous catheterization

et al. 2022

View full text Add to dashboard Cite

Background: Femorally inserted central catheters are increasingly used, especially after the COVID-19 pandemic, also thanks to widespread of tunneling techniques that allow the exit site to be moved away from the groin. Methods: In this retrospective observational study, femorally inserted catheters, with exit site at mid-thigh and the tip in Inferior vena cava or in Inferior vena cava at the junction with right atrium, have been observed and complications have been analyzed. All catheters were inserted by trained Nurses of a tertiary hospital Vascular Access Team. Results: In 142 catheters (126 inserted via common femoral vein and 16 inserted via superficial femoral vein) and 3060 catheter days, we observed an infection rate of 1.3 events/1000 catheter days (all of them in oncologic patients and up to 30 days of catheterization), 2 cases of thrombotic events (1.41%) and 17 cases of accidental removal (11.97%). Other rare complications, as primary malposition, tip migration, arterial pseudoaneurysm, have been recorded. The average length of catheters inserted, from the exit site to the tip, was 47.6 ± 2.4 cm. Conclusion: The attention to the correct position of the tip, the exit site at mid-thigh and the new techniques during insertion make these femoral catheters as safe as other central vascular access devices. For this kind of central access device, a catheter at least 50 cm long is needed.

show abstract

Catheter-related bloodstream infection associated with multiple insertions of the peripherally inserted central catheter in patients with hematological disorders

Cited by 9 publications

References 26 publications

Peripherally Inserted Central Venous Catheter-Related Complications in Adult Patients with Haematological Malignancy

Peripherally Inserted Central Venous Catheter-Related Complications in Adult Patients with Haematological Malignancy

Peripherally Inserted Central Venous Catheter (PICC) Related Bloodstream Infection in Cancer Patients Treated with Chemotherapy Compared with Noncancer Patients: A Propensity-Score-Matched Analysis

Femorally inserted central catheters with exit site at mid-thigh: A low risk alternative for central venous catheterization

Contact Info

Product

Resources

About