Jornal de doenças infecciosas e terapia

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Is it Safe to Place a Peripherally Inserted Central Catheter Line in Patients with Bacteremia? A Retrospective Cohort Study at a Single Institution

Joud G Almogati*, 

Background: The use of peripherally inserted central catheter (PICC) lines has steadily grown in hospital settings. We investigated the factors associated with positive blood cultures after PICC line insertion. We also assessed whether pre-PICC blood culture status affects post-insertion blood stream infection (BSI).
Methods: A retrospective record review was conducted for all hospitalized patients receiving PICC lines at King Abdul-Aziz University Hospital (Jeddah, Saudi Arabia) from February 2015 through January 2017. Two groups were studied according to pre-PICC line blood culture status (i.e., the positive blood culture and negative blood culture groups prior to PICC line insertion). Information regarding fever, white blood cell (WBC) count, and blood cultures performed during or after PICC line removal was collected.
Results: The sample included a total of 202 patients with PICC lines. We found a statistically significant relationship between PICC line-associated BSI and increased dwell time of PICC insertion (p=0.0001), increased length of hospital stay (p=0.0001), and non-Saudi nationality (p=0.025), respectively. Positive blood cultures during or after the removal of PICC lines were not significantly dependent on prior positive cultures or high WBC count.
Conclusion: The incidence of BSI after PICC line insertion in patients with prior positive culture was no different from that of patients without prior positive culture. These cultures included positive blood or any other cultures. Factors associated with BSI after PICC line insertion at King Abdul-Aziz University Hospital included dwell time of the PICC line, length of hospital stay, and non-Saudi nationality.