Impact of catheter dwell time on peripheral venous catheter associated bloodstream infections
Abstract:
Background: Peripheral intravenous catheter (PVC) insertion is the most frequent invasive medical procedure in hospitals worldwide. PCV-associated bloodstream infections (PVC-BSIs) are rare, but severe and preventable infections.
Aim: To study the impact of catheter dwell-time on infection risk and to investigate the incidence of PVC-BSIs.
Methods: This observational cohort study evaluated all adult hospitalized patients with a PVC insertion in Helsinki University Hospital, Finland between January 1, 2021, and December 31, 2023. Characteristics of inserted PVCs and PVC-BSI cases were identified.
Findings: A total of 548,633 PVCs were inserted among 208,073 patients during the study period. Median patients age was 66.0 (IQR 46.0-76.0) years and 48% were male. The median PVC dwell time was 1.6 (IQR 0.9-2.9) days. We observed 134 PVC-BSIs, representing 0.02% of all inserted PVCs. Staphylococcus aureus caused 89% of PVC-BSIs, and overall, all but one PVC-BSIs were due to Gram-positive bacteria. The risk of infection increased markedly with longer dwell time, with the sharpest rise observed on catheter-day 5. Mixed effects logistic regression models revealed dwell time (OR 1.10; 95% CI 1.06-1.14; p < 0.001) and insertion sites; both wrist (OR 3.28; 95% CI 1.74-6.19; p <0.001) and cubital fossa (OR 2.64; 95% CI 1.57-4.43; p <0.001) when compared with hand, as risk factors for PVC-BSIs. Insertion of PVC in medical wards, emergency departments and ICUs also increased odds of infection when compared with operative wards.
Conclusion: The results of this cohort study, based on a large prospective surveillance dataset, indicate that dwell time is associated with the development of PVC-BSIs.
Reference:
Ala-Houhala M, Lääperi M, Kainulainen K, Huotari K. Impact of catheter dwell time on peripheral venous catheter associated bloodstream infections. J Hosp Infect. 2026 Mar 18:S0195-6701(26)00087-3. doi: 10.1016/j.jhin.2026.03.006. Epub ahead of print. PMID: 41862137.