title: Peripherally inserted central venous catheter-associated bloodstream infections in hospitalized adult patients.
abstract: BACKGROUND
  Limited data on the risk of peripherally inserted central venous catheter-associated bloodstream infections (PICC BSIs) in hospitalized patients are available. In 2007, dedicated intravenous therapy nurses were no longer available to place difficult peripheral intravenous catheters or provide PICC care Barnes-Jewish Hospital.
  
  
  OBJECTIVE
  To determine the hospital-wide incidence of PICC BSIs and to assess the effect of discontinuing intravenous therapy service on PICC use and PICC BSI rates.
  
  
  METHODS
  A 1,252-bed tertiary care teaching hospital.
  
  
  METHODS
  A 31-month retrospective cohort study was performed. PICC BSIs were defined using National Healthcare Safety Network criteria.
  
  
  RESULTS
  In total, 163 PICC BSIs were identified (3.13 BSIs per 1,000 catheter-days). PICC use was higher in intensive care units (ICUs) than non-ICU areas (PICC utilization ratio, 0.109 vs 0.059 catheter-days per patient-day for ICU vs non-ICU; rate ratio [RR], 1.84 [95% confidence interval {CI}, 1.78-1.91]). PICC BSI rates were higher in ICUs (4.79 vs 2.79 episodes per 1,000 catheter-days; RR, 1.7 [95% CI, 1.10-2.61]). PICC use increased hospital-wide after the intravenous therapy service was discontinued (0.049 vs 0.097 catheter-days per patient-day; P =.01), but PICC BSI rates did not change (2.68 vs 3.63 episodes per 1,000 catheter-days; P =.06). Of PICC BSIs, 73% occurred in non-ICU patients.
  
  
  CONCLUSIONS
  PICC use and PICC BSI rates were higher in ICUs; however, most of the PICC BSIs occurred in non-ICU areas. Reduction in intravenous therapy services was associated with increased PICC use across the hospital, but PICC BSI rates did not increase.
authors: Department of Medicine, Washington University School of Medicine, St. Louis, Missouri, USA.
authors: M Cristina
authors: MC
authors: Ajenjo
authors: James C
authors: JC
authors: Morley
authors: Anthony J
authors: AJ
authors: Russo
authors: Kathleen M
authors: KM
authors: McMullen
authors: Catherine
authors: C
authors: Robinson
authors: Robert C
authors: RC
authors: Williams
authors: David K
authors: DK
authors: Warren
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002406:Catheterization, Peripheral / Q000009:adverse effects* / Q000706:statistics & numerical data; D002408:Catheters, Indwelling / Q000009:adverse effects* / Q000382:microbiology; D003428:Cross Infection / Q000453:epidemiology* / Q000209:etiology* / Q000382:microbiology; D005260:Female; D006784:Hospitals, Teaching; D006801:Humans; D007362:Intensive Care Units; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D008923:Missouri / Q000453:epidemiology; D012189:Retrospective Studies; D018805:Sepsis / Q000453:epidemiology* / Q000209:etiology* / Q000382:microbiology; D016896:Treatment Outcome; D055815:Young Adult