title: Is an increased dwell time of a peripherally inserted catheter associated with an increased risk of bloodstream infection in infants?
abstract: OBJECTIVE
  To estimate the risk of bloodstream infection associated with catheter dwell time in infants.
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  Duke University Medical Center neonatal intensive care unit, an academic, level 3 nursery in Durham, North Carolina.
  
  
  METHODS
  A case of catheter-associated bloodstream infection was defined as one that occurred in an infant whose culture-positive blood sample was collected more than 24 hours after catheter insertion or within 72 hours after catheter removal. We used multivariable logistic regression to control for the catheter's position and dwell time as well as the infant's sex, gestational age, age at time of catheter insertion, birth weight, and weight at time of catheter insertion.
  
  
  RESULTS
  We identified 135 cases of catheter-associated bloodstream infection. The mean catheter dwell time was 12.2 days (range, 0-113 days), and the mean time to bloodstream infection was 10.8 days (range, 1-57 days). An increase in catheter dwell time was associated with a lower risk of bloodstream infection (odds ratio, 0.975 [95% confidence interval, 0.954-0.996]; P = .02).
  
  
  CONCLUSIONS
  No increased risk of catheter-associated bloodstream infection was observed with increased catheter dwell time. This may have been due to the infant's improved nutrition, decreased need for other invasive devices, and maturing skin and immune system as catheter dwell time increased.
authors.affiliation: Department of Pediatrics, Duke University, Durham, North Carolina 27715, USA. brian.smith@duke.edu
authors.forename: P Brian
authors.initials: PB
authors.lastname: Smith
authors.forename: Daniel K
authors.initials: DK
authors.lastname: Benjamin
authors.forename: C Michael
authors.initials: CM
authors.lastname: Cotten
authors.forename: Eric
authors.initials: E
authors.lastname: Schultz
authors.forename: Rose
authors.initials: R
authors.lastname: Guo
authors.forename: Lisa
authors.initials: L
authors.lastname: Nowell
authors.forename: Mary Laura
authors.initials: ML
authors.lastname: Smithwick
authors.forename: Courtney D
authors.initials: CD
authors.lastname: Thornburg
mesh_terms: D000046:Academic Medical Centers; D016470:Bacteremia / Q000453:epidemiology* / Q000209:etiology; D002406:Catheterization, Peripheral / Q000009:adverse effects*; D002408:Catheters, Indwelling / Q000009:adverse effects*; D005260:Female; D006801:Humans; D052577:Infant, Extremely Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000453:epidemiology* / Q000209:etiology; D019102:Infant, Very Low Birth Weight; D007363:Intensive Care Units, Neonatal; D008297:Male; D009657:North Carolina; D018570:Risk Assessment; D013997:Time Factors