Patient- and device-specific risk factors for peripherally inserted central venous catheter-related bloodstream infections.
Infect Control Hosp Epidemiol. 2013 Feb;34(2):184-9
Authors: Pongruangporn M, Ajenjo MC, Russo AJ, McMullen KM, Robinson C, Williams RC, Warren DK
Abstract
Objective.?To determine the patient- and device-specific risk factors for hospital-acquired peripherally inserted central venous catheter-related bloodstream infections (PICC BSIs) in adult patients. Design.?Nested case-control study. Setting.?Barnes-Jewish Hospital, a 1,252-bed tertiary care teaching hospital. Patients.?Adult patients with PICCs placed from January 1, 2006, through July 31, 2008. Methods.?PICC BSI cases were identified using the National Healthcare Safety Network definition. Uninfected control patients with PICCs in place were randomly selected at a 3?1 ratio. Patient- and device-related variables were examined using multivariate analysis. Results.?The overall PICC BSI rate was 3.13 per 1,000 catheter-days. Independent risk factors for PICC BSIs included congestive heart failure (odds ratio [OR], 2.0 [95% confidence interval (CI), 1.26-3.17]; [Formula: see text]), intra-abdominal perforation (OR, 5.66 [95% CI, 1.76-18.19]; [Formula: see text]), Clostidium difficile infection (OR, 2.25 [95% CI, 1.17-4.33]; [Formula: see text]), recent chemotherapy (OR, 3.36 [95% CI, 1.15-9.78]; [Formula: see text]), presence of tracheostomy (OR, 5.88 [95% CI, 2.99-11.55]; [Formula: see text]), and type of catheter (OR for double lumen, 1.89 [95% CI, 1.15-3.10]; [Formula: see text]; OR for triple lumen, 2.87 [95% CI, 1.39-5.92]; [Formula: see text]). Underlying chronic obstructive pulmonary disease (OR, 0.48 [95% CI, 0.29-0.78]; [Formula: see text]) and admission to surgical (OR, 0.43 [95% CI, 0.24-0.79]; [Formula: see text]) or oncology and orthopedic (OR, 0.35 [95% CI, 0.13-0.99]; [Formula: see text]) services were less likely to be associated with having a PICC BSI. Conclusions.?We identified several novel factors related to PICC BSIs. These factors may inform preventive measures.
PMID: 23295565 [PubMed - in process]