Peripherally inserted central catheters may lower the incidence of catheter-related blood stream infections in patients in surgical intensive care units

Surgical Infections
Mark GunstHeidi Frankel

Abstract

Long-term central venous catheterization is associated with a higher rate of catheter-related blood stream infections (CR-BSI). It is unclear whether there is a difference in the CR-BSI rate associated with central venous catheters (CVCs) and peripherally inserted central catheters (PICCs) in long-stay patients in surgical intensive care units (SICUs). We hypothesized that PICC use reduces the rate of CR-BSI compared with use of antiseptic CVCs in these patients. All 121 patients admitted to our SICU for ≥14 days between July 2005 and July 2006 were included. Central venous access was maintained with an antiseptic CVC (Arrow Guard silver/chlorhexidine; n = 263) or replacement with a PICC (n = 37). Experienced residents, using maximum barrier precautions and chlorhexidine skin preparation, placed central lines; a credentialed registered nurse placed PICCs similarly. A CR-BSI was defined by semi-quantitative catheter tip cultures with ≥15 colony-forming units and at least one positive blood culture with the same organism. Multivariable regression was performed to identify predictors of CR-BSI. There were 13 CVC infections and one PICC infection, resulting in an infection rate of 6.0/1,000 catheter-days for CVCs and 2.2/1,000 for ...Continue Reading

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