The incidence and risk factors of peripherally inserted central catheter-related infection among cancer patients

Abstract

BackgroundAs the use of peripherally inserted central catheters (PICCs) increased in chemotherapy, the identification of complications and risk factors became essential to prevent patient harm. But little is known about PICC-related infection and risk factors among patients with cancer. Our study was to identify the prevalence, patterns, and risk factors of catheter-related infections associated with PICCs.MethodsA 3-year prospective cohort study was conducted in a university-affiliated hospital. All patients with cancer who met inclusion criteria were enrolled. The patients were followed up until catheter removal. Tip cultures were routinely performed at the time of catheter removal. The general information was recorded at the time of PICC insertion, weekly care, and removal. Univariable and multivariable logistic regression analyses were applied for identification of risk factors.ResultsIn total, 912 cancer patients with 912 PICCs of 96,307 catheter days were enrolled. Ninety-four developed PICC-related infection; 46 were exit-site infection, 43 were catheter bacterial colonization, and five were PICC-related bloodstream infection. The median time from catheter insertion to infection was 98.26 days. Multivariate analysis showed StatLock fixing (odds ratio [OR] =0.555, 95% confidence interval [CI]: 0.326–0.945) and tip position located in the lower one-third of the superior vena cava (OR =0.340, 95% CI: 0.202–0.571) were associated with lower PICC infection rate. Catheter care delay (OR =2.612, 95% CI: 1.373–4.969) and indwelling mostly in summer (OR =4.784, 95% CI: 2.681–8.538) were associated with higher infection incidence.ConclusionStatLock fixing and tip position located in the lower one-third of the superior vena cava were protective factors against PICC-related infection, while catheter care delay and indwelling mostly in summer were risk factors. Policy and measures targeting these factors may be necessary to reduce the risk of infection.

Bloodstream infections in neutropenic cancer patients: A practical update

“…86 Peripherally inserted central catheters (PICC) are commonly employed in cancer patients and in 2 cohorts the incidence of PICC-related BSIs was very low (0.05 per 1000 catheter days), although the incidence of localized PICC-associated infections and thrombosis was high. 87,88 Although CVC is associated with an increased risk of BSI, in neutropenic patients most of the infections are caused by translocation of intestinal bacteria. It has been estimated that approximately 40-50% of bloodstream infections in oncologic settings are due to mucosal barrier injury.…”

Influence of guide wire removal on tip location in peripherally inserted central catheters (PICCs): a retrospective cross-sectional study

“…Peripherally inserted central catheters (PICCs) play a fundamental role in intravenous therapy and treatment. PICCs have a wide range of applicability in different patients, including paediatric and elderly patients, patients with chronic or acute diseases, patients undergoing surgery or chemotherapy and patients who need parenteral nutrition and medication, such as antibiotics and fluids 1–4…”

The microbiological characteristics and risk factors for PICC-related bloodstream infections in intensive care unit

“…reported that multi-lumens and power PICC could increase the risk of PICC-related bloodstream infection 12 . A study based on cancer patients demonstrated that fixing method, indwelling season, catheter care, and tip position were significantly associated with incidence of PICC-related bloodstream infection 13 . Nevertheless, there was no consistent conclusion.…”