PICC infection in haematology patients
Abstract:
Objectives: We sought to investigate the nature and incidence of bloodstream infection complications and to identify the risk factors of CRBSI.
Methods: During the study period, 291 consecutive patients with hematological malignancies who underwent PICC placement were retrospectively enrolled. We analyzed the covariates that were specified a priori for their association with CRBSI through multivariate Cox proportional hazards regression models. The association between each predictor and related outcome was expressed using hazard ratios (HRs) with corresponding 95% confidence intervals (CIs).
Results: 391 PICCs were inserted in 291 patients for a total of 63 714 catheter days during 7 years, with an infection rate of 0.71/1000 catheter days. Among the patients with hematological malignancies, those with acute leukaemia were prone to CRBSI. Having previous bloodstream infection (BSI) (HR 18.139; 95% CI, 8.19-40.174; P<0.0001), the number of PICCs insertions (HR 4.695; 95% CI, 1.842-11.967; P=0.001) (twice), (HR 6.794; 95% CI, 1.909-24.181; P=0.003) (≥ three times) were significantly associated with CRBSI. Not accompanied by chronic comorbidities (HR 0.34; 95% CI, 0.131-0.887; P=0.028) and longer duration of PICC use (days) (HR 0.997; 95% CI, 0.994-0.999; P=0.008) might be protective factors preventing CRBSI.
Conclusions: Our finding suggests that previous BSI and a higher number of PICC insertions are associated with an increased risk of CRBSI. A lack of chronic comorbidities may help prevent CRBSI.
Reference:
Gao T, Zhu X, Zeng Q, Li X, Luo M, Yu C, Hu L, He J, Li Y, Yang Z, Yang H, Huang X, Gu X, Liu Z. Peripherally Inserted Central Catheter-Related Bloodstream Infections in Patients with Hematological Malignancies: a Retrospective 7-Years Single-Center Study. Am J Infect Control. 2022 Jan 30:S0196-6553(22)00057-8. doi: 10.1016/j.ajic.2022.01.016. Epub ahead of print. PMID: 35108580.