Abstract:
Introduction: While peripherally inserted central catheters (PICCs) are widely used, they remain associated with infectious risk. Even though the value of dedicated catheter teams is well-recognized, evidence regarding vascular access units is limited. This study compared catheter-related bloodstream infection (CRBSI) rates between a Vascular and Interventional Angiography Unit (VIAU) (insertion performed by physicians) and a newly established Vascular Access Unit (VAU) (insertion performed by nurse anesthetists under anesthesiologists’ supervision).
Patients and methods: A retrospective study was conducted in a French university hospital, including patients having undergone PICC insertion from January 2017 to June 2020 (VIAU) and from January to June 2020 (VAU). CRBSI rates during catheter dwell time and within 8 days after PICC insertion were compared. Risk factors for CRBSI were assessed using logistic regression analysis.
Results: Among 3332 inserted PICCs, 266 (8.0%) CRBSIs occurred during catheter dwell time, with no significant difference between the VIAU (7.7%) and the VAU (9.3%). In multivariate analysis, the risk of CRBSI between the VIAU and the VAU did not significantly differ (adjusted OR = 0.978 [95%CI, 0.558-1.714]); non-metastatic cancer was associated with a higher risk of CRBSI, whereas older age appeared protective. The 8-day CRBSI rate (0.9%) was similar between the two departments (0.9% for the VIAU and 1.0% for the VAU). Slightly more than half of the CRBSIs were caused by Staphylococcus species, and one third by Gram-negative bacteria.
Discussion – Conclusion: CRBSI rates between the established and the newly created units were similar. These results suggest that a dedicated vascular access unit staffed by trained professionals can achieve outcomes comparable to those obtained by an experienced unit.
Reference:Bonhomme F, Gallouche M, Majester A, Goudon H, Briot E, Rodiere M, Landelle C. Incidence of catheter-related bloodstream infections after PICC insertion: Impact of a newly established vascular access unit in a French university hospital. Infect Dis Now. 2026 Oct 17:105374. doi: 10.1016/j.idnow.2026.105374. Epub ahead of print. PMID: 42892499.