Environmental Risk Factors for Developing Catheter‐Related Bloodstream Infection in Home Parenteral Nutrition Patients

Abstract

Using the PICC, 1 additional infusion day per week decreased the time to first CRBSI, while having the Hickman catheter managed by a home care nurse increased the mean CRBSI incidence. No other risk factors were found.

American Society for Parenteral and Enteral Nutrition Guidelines for the Selection and Care of Central Venous Access Devices for Adult Home Parenteral Nutrition Administration

“…In addition to Cotogni et al, 7 3 other studies compared CLABSI rates in tunneled vs PICC CVADs. 11,13,14 Christenson and associates and Bech and associates appeared to analyze the same dataset of Danish HPN patients, and while different questions were asked, similar results were found. Christensen et al 14 reported higher CLABSI rates for PICC compared with tunneled CVADs and a shorter time to first infection (84 ± 94 days vs 297 ± 387 days; P < .05).…”

“…In addition to Cotogni et al, 3 other studies compared CLABSI rates in tunneled vs PICC CVADs . Christenson and associates and Bech and associates appeared to analyze the same dataset of Danish HPN patients, and while different questions were asked, similar results were found.…”

“…Rationale 1 : No randomized controlled trials were found that addressed this question. Nine observational studies were found that compared CLABSI and types of CVAD . An observational study of severely ill cancer patients compared CLABSI rates in tunneled, implanted, or PICC VADs, and found no significant difference between the groups even though implanted ports had a longer dwell time .…”

Short- and Intermediate-Term Use of Peripherally Inserted Central Catheters in Europe: A Systematic Literature Review

“…The incidence of catheter-related bloodstream infections (CRBSI) with PICCs varied among different studies and ranged from 0 to 1.63 per 1000 catheter days. 4,5,17,[22][23][24]31,34,38 In the study by Cotogni et al, 5 CRBSI rate was significantly lower with PICCs compared to CICCs (0 vs. 0.87 per 1000 catheter days, P < 0.01), and in the study by Botella-Carretero et al, 17 only PICCs, but not CICCs, showed lower CRBSI incidence than with implanted ports (P = 0.043). However, a higher CRBSI rate and a lower time to first CRBSI were reported for PICCs versus CICCs in a 6-year follow-up study in HPN patients (1.43 ± 0.20 vs. 0.95 ± 0.39 per 1000 catheter days, 83.91 ± 93.75 vs. 297.21 ± 386.91 days, P < 0.001).…”

“…The reported mean catheter dwell time/duration ranged from 9.4 to 127 days with PICCs 6,10-12,15,16,18,22-35 versus 4.4 to 7.3 days with PIVCs 6,10 and 6.83 to 324.92 days with CICCs. 6,11,16,22,28,33 In 2 studies, mean catheter dwell time was significantly higher for PICCs versus CICCs (P < 0.0001), 11,16 whereas the opposite was true in 2 other studies (P < 0.001). 22,33 In the study by Periard et al 10 in patients requiring IV therapy for at least 5 days, mean catheter dwell time was significantly higher for PICCs compared to PIVCs (9.4 vs. 7.3 days, P = 0.01).…”