Five-year outcome of peripherally inserted central catheters in adults: a separated infectious and thrombotic complications analysis

Abstract

Objective: To assess infectious and thrombotic complications of peripherally inserted central catheters (PICCs) in adults. Design: A 5-year prospective cohort study. Setting: Tertiary-care teaching hospital in Seville, Spain. Patients: Adult patients undergoing PICC insertion. Methods: Catheter-associated bloodstream infection (CABSI) including catheter-related bloodstream infection (CRBSI), primary bacteremia (PB), and upper extremity deep vein thrombosis (UEDVT) were recorded. Independent predictors of complications were assessed by multivariate analysis. Results: In total, 1,142 PICCs were inserted, with 153,191 catheter days (median, 79). Complications included 66 cases of CABSI (5.78%; 0.43‰ catheter days), 38 cases of CRBSI (3.33%; 0.25‰ catheter days), 28 cases of PB (2.45%; 0.18‰ catheter days), and 23 cases of UEDVT (2.01%; 0.15‰ catheter days). The median times to infection were 24, 41, and 60 days for CRBSI, PB, and UEDVT, respectively. Parenteral nutrition (odds ratio [OR], 3.40; 95% confidence interval [CI], 1.77–6.52) and admission to the hematology ward (OR, 4.90; 95% CI, 2.25–10.71) were independently associated with CRBSI and PB, respectively. Admission to the hematology ward (OR, 12.46; 95% CI, 2.49–62.50) or to the oncology ward (OR, 7.89; 95% CI, 1.77–35.16) was independently associated with UEDVT. The crude mortality rate was 24.8%. Only 2 patients died of complications. Conclusions: PICCs showed a low rate of thrombotic and infectious complications. Compared to PB, CRBSI showed significantly different risk factors, a higher incidence density per catheter days, and a shorter median time to infection. Separate analyses of CRBSI and PB are more specific and clinically useful when analyzing infectious complications.

Clinical factors associated with peripherally inserted central catheters (PICC) related bloodstream infections: a single centre retrospective cohort

“…First, the single centre design of the study could limit extrapolation of the results. Second, the relatively small size of our cohort limited the weight of some factors such as BMI > 40 kg/m 2 , number of lumen or total parenteral nutrition which are recognized at risk factors for CR-BSI [ 40 , 57 ]. However, to the best of our knowledge, this study is the first to analyse the association between clinical signs and PR-BSI.…”

COVID-19 Secondary Infections in ICU Patients and Prevention Control Measures: A Preliminary Prospective Multicenter Study

“…ICU-acquired bloodstream infections were reported to have an increased incidence in COVID-19 patients admitted to the ICU [ 46 , 47 ]. In a matched-case cohort study, COVID-19 increased the daily risk of developing ICU-acquired bloodstream infections with an HR of 4.5 (95% CI: 1.82–11.16; p = 0.001), with coagulase-negative Staphylococci being the microorganism most frequently identified among COVID-19 patients [ 47 ].…”

Analysis of risk factors of PICC-related bloodstream infection in newborns: implications for nursing care

“…Neonates have low immunity and poor resistance to infection, and they are a high-risk group of nosocomial infections. PICC placement can increase the risk of nosocomial infections [13]. A multi-center case-control study [14] have showed that after PICC catheterization for more than 2 weeks, the risk of CRBSI continues to increase with the extension of PICC stay.…”