Objective:
To estimate blood stream infection risk associated with catheter dwell time.
Design:
We performed a retrospective study of 1540 peripherally inserted catheters placed in 882 infants from August 2002 until November 2005.
Setting:
The Duke University Medical Center Neonatal Intensive Care Unit is an academic level III nursery.
Methods:
A catheter related blood stream infection was defined as a positive blood culture that was documented >24 hours after catheter placement or within 72 hours of catheter removal. We used multivariable logistic regression to control for dwell time of catheter, weight at insertion, birth weight, gestational age, day of insertion, position of catheter, and gender.
Results:
We identified 135 cases of catheter related blood stream infection. The mean catheter dwell time was 12.2 days (range, 0-113 days) and mean time to blood stream infection 10.8 days (range, 1-57 days). Increasing catheter dwell time was associated with a lower risk of blood stream infection (OR 0.975; 95% CI, 0.954-0.996, P=0.02).
Conclusions:
No increase risk of catheter related blood stream infection was observed with increasing catheter dwell time. This may have been due to improved nutrition, decreased need for other invasive devices, and maturation of the infants' skin and immune system as catheter dwell time increased.
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