How long should peripherally inserted central catheterization be delayed in the context of recently documented bloodstream infection?
J Vasc Interv Radiol. 2012 Jan;23(1):123-5
Authors: Daneman N, Downing M, Zagorski BM
Abstract
The risk of relapsing bacteremia was assessed retrospectively among a cohort of 348 patients who underwent peripherally inserted central catheter (PICC) insertion within 6 weeks of a documented bacteremia. The overall risk of relapsing bacteremia was low (three of 348; 0.9%) when PICC insertion was performed in the context of a recent bloodstream infection. The relapse risk was higher when PICCs were inserted within 2 days (two of 31; 6.5%) versus at least 3 days (one of 317; 0.3%) after documentation of bacteremia (P = .02).
PMID: 22221476 [PubMed - indexed for MEDLINE]
Most patients with bacteremia (particularly with line infections) will need to have central vascular access placed for long-term (2-6 weeks) IV antibiotics. Typically, IV antibiotics are administered initially via short-term peripheral IV in the hospital until central access can be placed, at which point the patient can be discharged if otherwise stable. There is concern that if the central access is placed too soon after bacteremia, the new access will become infected.
How long do you typically wait before placing central access after documented bacteremia?