title: Peripheral intravenous catheter-associated Staphylococcus aureus bacteraemia: more than 5 years of prospective data from two tertiary health services.
abstract: OBJECTIVE
  To determine the incidence, risk factors for and outcomes of Staphylococcus aureus bacteraemia (SAB) associated with peripheral intravenous catheters (PIVCs).
  
  
  METHODS
  A review of prospectively collected data from two tertiary health services on all health care-associated SAB episodes occurring in adults aged > 17 2013s from January 2007 to July 2012.
  
  
  METHODS
  Numbers of health care-associated SAB episodes; device type, location of insertion, device dwell time and outcome at 7 and 30 days for all SAB episodes associated with use of a PIVC; rates of SAB per 10 000 occupied bed-days (OBDs).
  
  
  RESULTS
  Overall, 137 of 583 health care-associated-SAB episodes (23.5%) were deemed to be PIVC associated, with an incidence of 0.26/10 000 OBD. The mean dwell time for PIVCs was 3.5 days (range, 0.25-9 days) and 45.2% of SABs occurred in PIVCs with a dwell time ≥ 4 days. Of the PIVC-associated SAB episodes, 39.6% involved PIVCs inserted in the ED, 39.6% involved PIVCs inserted on wards and 20.8% involved PIVCs inserted by the ambulance service. Of the PIVC-associated SABs occurring within 4 days of insertion, 61% were inserted by ED staff or the ambulance service. PIVC-associated SAB were associated with a 30-day all-cause mortality rate of 26.5%.
  
  
  CONCLUSIONS
  PIVC-associated SAB is an under-recognised complication. The high incidences of SAB associated with PIVCs inserted in emergency locations and with prolonged dwell times support recommendations in clinical guidelines for routine removal of PIVCs.
authors.affiliation: Monash Infectious Diseases, Monash Health, Melbourne, VIC. rhonda.stuart@southernhealth.org.au
authors.forename: Rhonda L
authors.initials: RL
authors.lastname: Stuart
authors.forename: Donna R M
authors.initials: DR
authors.lastname: Cameron
authors.forename: Carmel
authors.initials: C
authors.lastname: Scott
authors.forename: Despina
authors.initials: D
authors.lastname: Kotsanas
authors.forename: M Lindsay
authors.initials: ML
authors.lastname: Grayson
authors.forename: Tony M
authors.initials: TM
authors.lastname: Korman
authors.forename: Elizabeth E
authors.initials: EE
authors.lastname: Gillespie
authors.forename: Paul D R
authors.initials: PD
authors.lastname: Johnson
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016470:Bacteremia / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality; D055499:Catheter-Related Infections / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality; D002406:Catheterization, Peripheral / Q000009:adverse effects*; D003428:Cross Infection / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011446:Prospective Studies; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality; D062606:Tertiary Care Centers; D014739:Victoria / Q000453:epidemiology; D055815:Young Adult