Previous peripherally inserted central catheter (PICC) placement as a risk factor for PICC-associated bloodstream infections
2020
Background Peripherally inserted central catheter (PICC) -associated bloodstream infection (BSI) is a concern. Methods A case-control study was conducted to assess risk factors for PICC-associated BSI. Results A total of 1,215 cases and 31,874 catheter days were analyzed. In total, 54 cases of PICC-associated BSI were detected giving an infection rate of 1.69 per 1,000 catheter-days. The most frequently isolated pathogens were coagulase-negative staphylococci (26%), followed by Enterococcus species (22%), Candida species (17%), and Staphylococcus aureus (11%). Multivariable analysis identified the significant risk factors for PICC-associated BSI as a prior PICC placement (odds ratio [OR], 2.48; 95% confidence interval [CI], 1.36-4.53), medical department admission (OR, 1.89; 95% CI, 1.03-3.46), and older age (OR, 1.03; 95% CI, 1.00-1.05). With increasing frequency of previous PICC placement, the rates of PICC-associated BSI increased: 3.5% (31/883) without previous placement, 7.6% (13/171) in once, and 9.9% (9/32) in twice or more. Discussion The previous PICC placement was an independent risk factor for PICC-associated BSI and the risk proportionally rose with the increasing frequency of prior PICC placement. Conclusions Patients with repeatedly inserted PICC should be managed more carefully for prevention and should be monitored for the development of PICC-associated BSI.
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