Peripheral venous catheter-related bloodstream infection is associated with severe complications and potential death: a retrospective observational study

Abstract

BackgroundThe purpose of this study was to identify the clinical characteristics and outcomes of peripheral vascular catheter-related bloodstream infections (PVC-BSIs) and determine the risk of severe complications or death.MethodsWe performed a retrospective observational study from June 2010 to April 2015 at two regional university-affiliated hospitals in Tokyo. We studied the clinical manifestations, underlying diseases, laboratory results, treatment methods, recurrence rates, and complications in 62 hospitalized patients diagnosed with PVC-BSIs by positive blood cultures.ResultsThe median time from admission to bacteremia was 17 days (range, 3–142 days) and that from catheter insertion to bacteremia diagnosis was 6 days (range, 2–15 days). Catheter insertion sites were in the arm in 48 (77.4%) patients, in the foot in 3 (4.8%) patients, and in an unrecorded location in 11 (17.7%) patients. Additionally, the causative pathogens were Gram-positive microorganisms in 58.0% of cases, Gram-negative microorganisms in 35.8% of cases, Candida spp. in 6.2% of cases, and polymicrobials in 25.8% of cases. Eight (12.9%) patients died within 30 days of their blood culture becoming positive. Patients who died of PVC-BSIs had a higher proportion of Staphylococcus aureus infection than patients who survived (odds ratio, 8.33; p = 0.004).ConclusionsPVC-BSIs are a significant cause of health care-associated infection. We observed cases of severe PVC-BSI requiring intensive and long-term care along with lengthy durations of antibiotic treatment due to hematogenous complications, and some patients died. For patients with PVC-BSIs, S. aureus bacteremia remains a major problem that may influence the prognosis.

Implementation of Intravenous Drip Infusion Therapy with Peripheral Venous Catheters and the Incidence of Related Complications in Home-Based Medical Care Settings in Japan

“…The reported frequency of PVC-related bloodstream infections was quite low, ranging from 0.08 to 6.9% for local infections and 0.036 to 0.1% for severe systemic infections, respectively [9,10]. However, once these infections present, they are associated with high morbid- ity and mortality [11]. Even though the incidence rate of thrombophlebitis is 6.8-21.7%, we did not observe this complication in our study period [12,13].…”

Short-Term Peripheral Venous Catheter-Related Bloodstream Infections: Evidence for Increasing Prevalence of Gram-Negative Microorganisms from a 25-Year Prospective Observational Study

“…Current clinical practice guidelines (8) do not specifically refer to PVC tip culture and suggest systematic removal and culture of the catheter in case of suspected intravascular catheter-related bloodstream infection. Moreover, data regarding the proportion of PVC tip cultures performed in patients with suspected PVCRBSI are scarce, and when reported the proportion is frequently under 50% (18,19). Given these findings, we may conclude that a systematic removal and culture of PVC should be performed not only in all patients with clinical apparent phlebitis but also in subjects with systemic signs of infection and without a known septic focus.…”

Catheter dwell time and risk of catheter failure in adult patients with peripheral venous catheters

“…Therefore, patients who remain on PVC for longer than the routine indwelling time might be more susceptible to infection. To our knowledge, although the incidence of infection is very low, the literature indicates that once the infection occurs, the patient's hospital stay will be prolonged, and mortality can even occur (Guembe et al, ; Sato et al, ).…”

“…Some studies have reported that increased dwell time may increase the risk of PVC failure in adult patients (Cicolini, Manzoli, et al, 2014a;Mermel, 2017;Sato et al, 2017), while some studies have also indicated there was no association between catheter dwell time and phlebitis (Braga et al, 2018), and catheter-related infections (Guembe et al, 2017). These inconsistent findings may be related to various confounding factors.…”