Prevention of peripheral intravenous catheter‐related bloodstream infections: the need for routine replacement

Collignon, Peter; Kimber, Fiona; Beckingham, Wendy; Roberts, Jan L.

doi:10.5694/mja13.10735

Cited by 9 publications

(5 citation statements)

References 7 publications

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“…In different studies, the risk of acquiring BSI was not as high if PVCs were used instead of central lines. [31][32][33] In our ICUs, the pooled mean of the distribution of crude mortality amounted to 18% of PVCR-BSIs cases, compared with 6.67% mortality of with PVC patients that were not infected. In recent studies from Spain and Japan, the mortality rates attributable to PVCR-BSI were 13.2% and 12.9%, respectively.…”

Section: Discussionmentioning

confidence: 87%

Six-year multicenter study on short-term peripheral venous catheters-related bloodstream infection rates in 727 intensive care units of 268 hospitals in 141 cities of 42 countries of Africa, the Americas, Eastern Mediterranean, Europe, South East Asia, and Western Pacific Regions: International Nosocomial Infection Control Consortium (INICC) findings

Rosenthal¹,

Bat-Erdene²,

Gupta

et al. 2020

Infect. Control Hosp. Epidemiol.

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Background:Short-term peripheral venous catheter–related bloodstream infection (PVCR-BSI) rates have not been systematically studied in resource-limited countries, and data on their incidence by number of device days are not available.Methods:Prospective, surveillance study on PVCR-BSI conducted from September 1, 2013, to May 31, 2019, in 727 intensive care units (ICUs), by members of the International Nosocomial Infection Control Consortium (INICC), from 268 hospitals in 141 cities of 42 countries of Africa, the Americas, Eastern Mediterranean, Europe, South East Asia, and Western Pacific regions. For this research, we applied definition and criteria of the CDC NHSN, methodology of the INICC, and software named INICC Surveillance Online System.Results:We followed 149,609 ICU patients for 731,135 bed days and 743,508 short-term peripheral venous catheter (PVC) days. We identified 1,789 PVCR-BSIs for an overall rate of 2.41 per 1,000 PVC days. Mortality in patients with PVC but without PVCR-BSI was 6.67%, and mortality was 18% in patients with PVC and PVCR-BSI. The length of stay of patients with PVC but without PVCR-BSI was 4.83 days, and the length of stay was 9.85 days in patients with PVC and PVCR-BSI. Among these infections, the microorganism profile showed 58% gram-negative bacteria: Escherichia coli (16%), Klebsiella spp (11%), Pseudomonas aeruginosa (6%), Enterobacter spp (4%), and others (20%) including Serratia marcescens. Staphylococcus aureus were the predominant gram-positive bacteria (12%).Conclusions:PVCR-BSI rates in INICC ICUs were much higher than rates published from industrialized countries. Infection prevention programs must be implemented to reduce the incidence of PVCR-BSIs in resource-limited countries.

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Section: Discussionmentioning

confidence: 87%

Six-year multicenter study on short-term peripheral venous catheters-related bloodstream infection rates in 727 intensive care units of 268 hospitals in 141 cities of 42 countries of Africa, the Americas, Eastern Mediterranean, Europe, South East Asia, and Western Pacific Regions: International Nosocomial Infection Control Consortium (INICC) findings

Rosenthal¹,

Bat-Erdene²,

Gupta

et al. 2020

Infect. Control Hosp. Epidemiol.

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show abstract

“…A prospective study by Stuart et al 18 and commentary by Collignon et al 19 underscore the need for further research targeting blood stream infections (sepsis and severe sepsis in particular) as a primary outcome. Blood stream infections, especially those related to PIVC use, are rare entities overall, with most recent data yielding an estimated rate of 0.5 per 1000 catheter-days.…”

Section: Why You Should Not Routinely Replace Pivcsmentioning

confidence: 99%

Routine Replacement of Peripheral Intravenous Catheters

Patel

Alebich

Feldman

2017

Journal of Hospital Medicine

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“…The Hawthorne effect and strict inclusion and exclusion criteria mean that, while largely free of bias, the outcomes of clinical trials are not generalisable. The retrospective data on PIVC‐associated bloodstream infections reported by Stuart et al and Collignon et al, while methodologically limited, demonstrate the real‐world experience of hundreds of patients 1 , 2 …”

mentioning

confidence: 98%

“…To the Editor : Debate regarding the prevention of peripheral intravenous catheter (PIVC)‐associated bloodstream infection has been enriched by research and letters published in the Journal 1 . ‐ 3 Stuart and colleagues and Collignon and colleagues highlighted an association of long dwell times with PIVC‐associated bloodstream infection 1 , 2 . Rickard and colleagues refer to contrasting high‐level evidence in a Cochrane review 3 , 4 .…”

mentioning

confidence: 99%