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Patient- and Device-Specific Risk Factors for Peripherally Inserted Central Venous Catheter—Related Bloodstream Infections

Published online by Cambridge University Press:  02 January 2015

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

Objective.

To determine the patient- and device-specific risk factors for hospital-acquired peripherally inserted central venous catheter–related bloodstream infections (PICC BSIs) in adult patients.

Design.

Nested case-control study.

Setting.

Barnes-Jewish Hospital, a 1,252-bed tertiary care teaching hospital.

Patients.

Adult patients with PICCs placed from January 1, 2006, through July 31, 2008.

Methods.

PICC BSI cases were identified using the National Healthcare Safety Network definition. Uninfected control patients with PICCs in place were randomly selected at a 3: 1 ratio. Patient- and device-related variables were examined using multivariate analysis.

Results.

The overall PICC BSI rate was 3.13 per 1,000 catheter-days. Independent risk factors for PICC BSIs included congestive heart failure (odds ratio [OR], 2.0 [95% confidence interval (CI), 1.26–3.17]; P = .003), intra-abdominal perforation (OR, 5.66 [95% CI, 1.76–18.19]; P = .004), Clostidium difficile infection (OR, 2.25 [95% CI, 1.17–4.33]; P = .02), recent chemotherapy (OR, 3.36 [95% CI, 1.15–9.78]; P = .03), presence of tracheostomy (OR, 5.88 [95% CI, 2.99–11.55]; P < .001), and type of catheter (OR for double lumen, 1.89 [95% CI, 1.15–3.10]; P = .01; OR for triple lumen, 2.87 [95% CI, 1.39–5.92]; P = .004). Underlying chronic obstructive pulmonary disease (OR, 0.48 [95% CI, 0.29–0.78]; P = .03) and admission to surgical (OR, 0.43 [95% CI, 0.24–0.79]; P = .006) or oncology and orthopedic (OR, 0.35 [95% CI, 0.13–0.99]; P = .05) services were less likely to be associated with having a PICC BSI.

Conclusions.

We identified several novel factors related to PICC BSIs. These factors may inform preventive measures.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 34 , Issue 2 , February 2013 , pp. 184 - 189
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2013 

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