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KMID : 1033220240140010009
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Journal of Acute Care Surgery
2024 Volume.14 No. 1 p.9 ~ p.15
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Analysis of Risk Factors for Peripherally Inserted Central Venous Catheter-Associated Bloodstream Infection
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Lee Sung-Ho
Park Kwan-Hoon
Lee Kang-Yoon
Choi Dong-Been
Jang Ji-Young
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Abstract
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Purpose: Despite guidelines on the prevention of central venous line-associated bloodstream infection, itis left to the clinical judgment of the attending physician to determine the risk of infection and how longa central line should remain in place. This study aimed to identify risk factors for peripherally insertedcentral venous catheter (PICC)-associated infection.
Methods: This retrospective study included 1,136 patients with a PICC who were hospitalized at theNational Health Insurance Service Ilsan Hospital (January 2015 to January 2022). Electronic medicalrecords were reviewed for patients with positive blood cultures. Patients with suspicion of infection atthe PICC insertion site or with unclear infection at other sites were defined as having a PICC-associatedinfection.
Results: Thirty-five patients (3.08%) had a PICC-associated infection. There were significant differencesin hypertension (p
= 0.026), lung disease (p = 0.001), PICC duration > 14 days, and antibiotic use beforePICC insertion (p = 0.016) between no PICC-associated infection, and infection in the bloodstream.
Total parenteral nutrition with PICC was not significantly different between groups. Logistic regressionanalysis identified hypertension, lung disease, PICC duration > 14 days (OR 2.088, 95% CI 1.032-4.224, p = 0.041), and antibiotic use before PICC insertion (OR 0.159, 95% CI 0.049-0.515, p = 0.002) asindependent risk factors for PICC-associated infection.
Conclusion: The study suggested that PICCs maintained longer than 14 days is a risk factor for PICC-associated infection. Antibiotic use prior to PICC insertion was observed as a negative factor for PICC-associated infection.
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KEYWORD
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bloodstream infection, catheter, phlebitis, risk factors, sepsis
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