Peripherally inserted central catheters have a protective role and the effect of fluctuation curve feature in the risk of bloodstream infection compared with central venous catheters: a propensity-adjusted analysis

Yu Lv; Xiaobo Huang; Yunping Lan; Qi Xia; Fuli Chen; Jiayu Wu; Wei Li; Hongrong Cao; Caixia Xie; Luting Li; Hukui Han; Hui Wang; Qian Xiang

doi:10.1186/s12879-022-07265-x

BMC Infectious Diseases (Mar 2022)

Peripherally inserted central catheters have a protective role and the effect of fluctuation curve feature in the risk of bloodstream infection compared with central venous catheters: a propensity-adjusted analysis

Yu Lv,
Xiaobo Huang,
Yunping Lan,
Qi Xia,
Fuli Chen,
Jiayu Wu,
Wei Li,
Hongrong Cao,
Caixia Xie,
Luting Li,
Hukui Han,
Hui Wang,
Qian Xiang

Affiliations

Yu Lv: Healthcare-Associated Infection Management Office, Sichuan Academy of Medical Sciences, Sichuan People’s Hospital, School of Medicine, University of Electronic Science and Technology of China
Xiaobo Huang: Intensive Care Unit, Sichuan Academy of Medical Sciences, Sichuan People’s Hospital, School of Medicine, University of Electronic Science and Technology of China
Yunping Lan: Intensive Care Unit, Sichuan Academy of Medical Sciences, Sichuan People’s Hospital, School of Medicine, University of Electronic Science and Technology of China
Qi Xia: PICC Nursing Center, Sichuan Academy of Medical Sciences, Sichuan People’s Hospital, School of Medicine, University of Electronic Science and Technology of China
Fuli Chen: Interventional Treatment Center, Sichuan Academy of Medical Sciences, Sichuan People’s Hospital, School of Medicine, University of Electronic Science and Technology of China
Jiayu Wu: Healthcare-Associated Infection Management Office, Sichuan Academy of Medical Sciences, Sichuan People’s Hospital, School of Medicine, University of Electronic Science and Technology of China
Wei Li: Healthcare-Associated Infection Management Office, Sichuan Academy of Medical Sciences, Sichuan People’s Hospital, School of Medicine, University of Electronic Science and Technology of China
Hongrong Cao: Healthcare-Associated Infection Management Office, Sichuan Academy of Medical Sciences, Sichuan People’s Hospital, School of Medicine, University of Electronic Science and Technology of China
Caixia Xie: Department of Nursing, Sichuan Academy of Medical Sciences, Sichuan People’s Hospital, School of Medicine, University of Electronic Science and Technology of China
Luting Li: Development Department, Chengdu Yiou Technology Co. LTD
Hukui Han: Cardiology, Sichuan Academy of Medical Sciences, Sichuan People’s Hospital, School of Medicine, University of Electronic Science and Technology of China
Hui Wang: Healthcare-Associated Infection Management Office, Sichuan Academy of Medical Sciences, Sichuan People’s Hospital, School of Medicine, University of Electronic Science and Technology of China
Qian Xiang: Healthcare-Associated Infection Management Office, Sichuan Academy of Medical Sciences, Sichuan People’s Hospital, School of Medicine, University of Electronic Science and Technology of China

DOI: https://doi.org/10.1186/s12879-022-07265-x
Journal volume & issue: Vol. 22, no. 1
pp. 1 – 10

Abstract

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Abstract Background The prevention of peripherally inserted central catheters (PICC)-associated BSI and central venous catheters (CVC)-associated BSI have been a topic of national importance in China. Therefore, we aimed to explore the epidemiological characteristics of central line-associated bloodstream infection (CLABSI), and to evaluate whether PICCs were associated with a protective effect for CLABSI. Methods A retrospective cohort study was conducted in teaching hospital in Western China. All adult patients received a CVC or PICC during their hospital stay were included from January 2017 to December 2020. Primary endpoint was CLABSI up to 30 days after CVC or PICC placement. Propensity scores with a 2:1 match was used to account for potential confounders, and restricted cubic spline was used to visualize the risk of CLABSI at different time points during the catheterization. Results A total of 224687 devices (180522 PICCs and 45965 CVCs) in 24879 patients were included. The overall incidence was 1.8 CLABSIs per 1000 catheter-days. The odds ratio (OR) value increased day by day after PICC insertion, reached a relatively high point on the 4th day, and decreased from days 5 through 8. From the 9th day of intubation the OR value began to gradually increase day by day again. After covariate adjustment using propensity scores, CVCs were associated with higher risk of CLABSI (adjHR = 3.27, 95% CI 2.38–4.49) compared with PICCs. Conclusions PICCs have a protective role and the effect of fluctuation curve feature in CLABSI when compared to CVCs, and the first 8 calendar days after CVC insertion are the acute stage of CVC-associated BSI.

Published in BMC Infectious Diseases

ISSN: 1471-2334 (Online)
Publisher: BMC
Country of publisher: United Kingdom
LCC subjects: Medicine: Internal medicine: Infectious and parasitic diseases
Website: https://bmcinfectdis.biomedcentral.com

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