Peripherally inserted central catheter-related bloodstream infections in patients with hematological malignancies: A retrospective 7-years single-center study |
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| Institution: | 1. The First Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China;2. Department of Hematology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China;1. SHIP Research Group, Research Centre for Health, Glasgow Caledonian University, Glasgow, UK;2. Infection Control Programme and WHO Collaborating Center on Patient Safety, The University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland;3. Infection Prevention and Control Technical and Clinical Hub, Department of Integrated Health Services, World Health Organization, Geneva, Switzerland;1. Department of Obstetrics and Gynaecology, Ipswich Hospital, Chelmsford Avenue, Ipswich, Queensland, Australia;2. University of Queensland, Brisbane, Queensland, Australia;1. Department of Social Medicine, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil;2. Graduate Program in Public Health/Clinical Oncology, Stem Cells and Cell Therapy, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil;3. Dentistry Service. University Hospital of the Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil;4. School of Nursing of Ribeirão Preto, University of São Paulo, São Paulo, Brazil;5. Infection Control and Prevention Service. University Hospital of the Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil;6. Cardiology Division, Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil;7. Intensive Care Unit, University Hospital of the Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil;8. Intensive Care Medicine Division, Department of Surgery and Anatomy, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil;1. Prevention and Response Branch, Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, GA;2. Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA;3. Mycotic Diseases Branch, Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, GA;4. Arkansas Department of Health, Little Rock, AR |
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| Abstract: | ObjectivesWe sought to investigate the nature and incidence of bloodstream infection complications and to identify the risk factors of central catheter-related bloodstream infections (CRBSI).MethodsDuring the study period, 291 consecutive patients with hematological malignancies who underwent PICC placement were retrospectively enrolled. We analyzed the covariates that were specified a priori for their association with CRBSI through multivariate Cox proportional hazards regression models. The association between each predictor and the related outcome was expressed using hazard ratios (HRs) with corresponding 95% confidence intervals (CIs).ResultsOf 391 peripherally inserted central catheter (PICCs) were inserted in 291 patients for a total of 63,714 catheter days during 7 years, with an infection rate of 0.71/1,000 catheter days. Among the patients with hematological malignancies, those with acute leukemia were prone to CRBSI. Having previous bloodstream infection (BSI) (HR 18.139; 95% CI, 8.19-40.174; P < .0001), the number of PICCs insertions (HR 4.695; 95% CI, 1.842-11.967; P = .001) (twice), (HR 6.794; 95% CI, 1.909-24.181; P = .003) (≥3 times) were significantly associated with CRBSI. Not accompanied by chronic comorbidities (HR 0.34; 95% CI, 0.131-0.887; P = .028) and longer duration of PICC use (days) (HR 0.997; 95% CI, 0.994-0.999; P = .008) might be protective factors preventing CRBSI.ConclusionsOur finding suggests that previous BSI and a higher number of PICC insertions are associated with an increased risk of CRBSI. A lack of chronic comorbidities may help prevent CRBSI. |
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| Keywords: | Clinical research Hematology Peripheral catheter Cox hazard model |
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