Work

Incidence and Risk Factors for Peripherally Inserted Central Catheter-Associated Infections in Inpatient and Outpatient Settings

Year: 2015

Type: article

Abstract: Background. CLABSI rates and risks by catheter types are not clearly established. The use of PICC lines for administration of chemotherapy, antibiotics, and supportive therapy is increasingly becoming common especially as patients transition from inpatient to the ambulatory setting. This study aims to identify incidence rates and risk factors related to the development of primary PICC-associated infections among persons undergoing treatment for cancer. Methods. Memorial Sloan Kettering Cancer Center is a tertiary care center in NYC. Patients with PICC line placement for all indications between 1 November 2013 and 31 July 2014 were retrospectively identified from an institutional database. Positive blood cultures were obtained from microbiology surveillance reports and NHSN criteria were applied to establish if primary CLABSI event occurred. Patients were monitored for positive blood cultures between 1 November 2013 and 31 July 2014. Potential covariates were identified via chart review and included PICC placement setting (outpatient versus inpatient), service (if inpatient), age at time of procedure, current diabetes status, any history of radiation, any history of total parenteral nutrition (TPN), bicep circumference and catheter length measured in centimeters, and concurrent or a history of previous central lines. Fisher's exact tests were used to determine statistically significant differences. Results. During the study period, 920 PICCs were inserted in 766 patients. The overall incidence of PICC related infection was 2.71% (25 of 920). Hematologic malignancies, small arm circumference, and previous or concurrent catheter were significant predictors of infection. Gender, mean catheter length, and PICC placement in an outpatient setting were marginally associated with infection. Age, TPN, radiation, and diabetes status were not significant predictors of PICC infection. Conclusion. Our PICC rates are lower than previously described from our and other centers. We attribute this to catheter maintenance practices implemented since 2013. Persons with hematologic malignances and those with previous or concomitant central lines had a significantly higher risk for primary CLABSI events and should be a target population for supplemented catheter care interventions. Disclosures. All authors: No reported disclosures.

Source: Open Forum Infectious Diseases

DOI: 10.1093/ofid/ofv133.153

Authors: Rachel Blair, Jennifer Brite, Natalie Bell, Janet Eagan, Mini Kamboj

Institution: Memorial Sloan Kettering Cancer Center

Language: English

Topic: Central Venous Catheters and Hemodialysis

Subfield: Emergency Medical Services

Field: Health Professions

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $4,053