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Author: Pujol M et al. (2007) Source: Journal of Hospital Infection 67, 22–29.


Pujol M et al. (2007)

Clinical epidemiology and outcomes of peripheral venous catheter-related bloodstream infections at a university-affiliated hospital

Peripheral venous catheters (PVC) are increasingly used in the clinical setting and may lead to bloodstream infection (BSI) with severe course, particularly when they are elicited by invasive pathogens such as Staphylococcus aureus. Despite extensive clinical experience of using PVCs, there is still controversy over the incidence and clinical relevance of PVC-associated BSI and the preventive measures.

Method: The prospective study was conducted in a 900-bed university clinic in Barcelona, Spain between October 2001 and March 2003. The objective was to analyse the clinical epidemiology and the consequences of BSIs that were caused by short and mid-line infusions with PVCs in non-intensive care units. For this, cases of PVC-related BSIs were compared to data on central venous catheters (CVCs). The patients’ average age was 63.2 years.

Results: Among 147 patients, 150 cases of catheter-associated BSI were identified. 77 cases (0.19 cases/1 000 patient days) were caused by PVCs, 73 cases (0.18 cases/1 000 patient days) by CVCs. 42 % of the patients with PVC-related BSIs had the catheter inserted in the emergency unit; none of the patients with CVC-related BSIs had their catheters inserted there. The duration from catheter insertion to bacteraemia was shorter among patients with PVC-associated BSIs (4.9 vs 15.4 days) and the infections were more frequently caused by S. aureus (53 % vs 33 %). In addition, PVCs inserted in the emergency unit had a significantly shorter dwell time compared with the CVCs inserted in hospital wards (3.7 vs 5.7 days). Compared to BSIs caused by other pathogens, PVC-related BSIs caused by S. aureus had a higher rate of complicated bacteraemia (7 % vs 0 %) and higher overall mortality (27 % vs 11 %).

Conclusions: Bloodstream infection caused by, for example, S. aureus may involve severe complications. The authors recommend continuing research of risks linked to PVC insertion and consider the introduction of targeted interventions an important measure for reducing infection rates.

Journal of Hospital Infection 67, 22–29.

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