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Peripherally Inserted Central Venous Catheter–Associated Bloodstream Infections in Hospitalized Adult Patients

Published online by Cambridge University Press:  02 January 2015

M. Cristina Ajenjo ,
James C. Morley ,
Anthony J. Russo ,
Kathleen M. McMullen ,
Catherine Robinson ,
Robert C. Williams  and
David K. Warren
M. Cristina Ajenjo
Affiliation:
Department of Medicine, Washington University School of Medicine, St. Louis, Missouri Department of Internal Medicine, Infectious Diseases Program, Pontificia Universidad Católica de Chile, Santiago, Chile
James C. Morley
Affiliation:
Department of Economics, Washington University, St. Louis, Missouri
Anthony J. Russo
Affiliation:
Department of Economics, Washington University, St. Louis, Missouri
Kathleen M. McMullen
Affiliation:
Barnes-Jewish Hospital, St. Louis, Missouri
Catherine Robinson
Affiliation:
Barnes-Jewish Hospital, St. Louis, Missouri
Robert C. Williams
Affiliation:
Department of Medicine, Washington University School of Medicine, St. Louis, Missouri
David K. Warren*
Affiliation:
Department of Medicine, Washington University School of Medicine, St. Louis, Missouri Barnes-Jewish Hospital, St. Louis, Missouri
*
Infectious Disease Division, Washington University School of Medicine, Barnes-Jewish Hospital, 660 South Euclid Avenue, Campus Box 8051, St. Louis, MO 63110 (dwarren@dom.wustl.edu)
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Abstract

Background.

Limited data on the risk of peripherally inserted central venous catheter-associated bloodstream infections (PICC BSIs) in hospitalized patients are available. In 2007, dedicated intravenous therapy nurses were no longer available to place difficult peripheral intravenous catheters or provide PICC care Barnes-Jewish Hospital.

Objectives.

To determine the hospital-wide incidence of PICC BSIs and to assess the effect of discontinuing intravenous therapy service on PICC use and PICC BSI rates.

Setting.

A 1,252-bed tertiary care teaching hospital.

Methods.

A 31-month retrospective cohort study was performed. PICC BSIs were defined using National Healthcare Safety Network criteria.

Results.

In total, 163 PICC BSIs were identified (3.13 BSIs per 1,000 catheter-days). PICC use was higher in intensive care units (ICUs) than non-ICU areas (PICC utilization ratio, 0.109 vs 0.059 catheter-days per patient-day for ICU vs non-ICU; rate ratio [RR], 1.84 [95% confidence interval {CI}, 1.78-1.91]). PICC BSI rates were higher in ICUs (4.79 vs 2.79 episodes per 1,000 catheter-days; RR, 1.7 [95% CI, 1.10-2.61]). PICC use increased hospital-wide after the intravenous therapy service was discontinued (0.049 vs 0.097 catheter-days per patient-day; P = .01), but PICC BSI rates did not change (2.68 vs 3.63 episodes per 1,000 catheter-days; P = .06). Of PICC BSIs, 73% occurred in non-ICU patients.

Conclusions.

PICC use and PICC BSI rates were higher in ICUs; however, most of the PICC BSIs occurred in non-ICU areas. Reduction in intravenous therapy services was associated with increased PICC use across the hospital, but PICC BSI rates did not increase.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 32 , Issue 2 , February 2011 , pp. 125 - 130
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2011

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Footnotes

a

School of Economics, University of New South Wales, Sydney, Australia.

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