title: A role for peripherally inserted central venous catheters in the prevention of catheter-related blood stream infections in patients with hematological malignancies.
abstract: Central venous catheter-related blood stream infections (CR-BSIs) are a serious complication in patients with hematological malignancies. However, it remains unclear whether there is a difference in the rate of CR-BSI associated with the conventional type of central venous catheters (cCVCs) and peripherally inserted CVCs (PICCs) in such patients. To address this question, we retrospectively investigated the incidence of CR-BSIs associated with PICCs versus cCVCs in patients with hematological malignancies. We used PICCs in all consecutive patients requiring CVC placement between February 2009 and February 2013. We compared the CR-BSI rate in patients with PICCs with that in patients with cCVCs treated between September 2006 and January 2009 (control group). Eighty-four patients received PICCs and 85 received cCVCs. The most common reason for removal due to catheter-related complications was CR-BSI. The CR-BSI rate in the PICC group was significantly lower than that in the cCVC group (PICCs: 1.23/1000 catheter days; cCVCs: 5.30/1000 catheter days; P < 0.01). Catheter-related complications other than CR-BSIs occurred at an extremely low rate in the PICC group. The median catheter-related complication-free survival duration was significantly longer in the PICC group than in the cCVC group. Our study shows that PICCs are useful in patients with hematological malignancies.
authors.affiliation: Department of Hematology and Oncology, Asahikawa Red Cross Hospital, 1-1 Akebono-cho, Asahikawa, Hokkaido, Japan, to-sa0627@asahikawa-rch.gr.jp.
authors.forename: Toshiro
authors.initials: T
authors.lastname: Sakai
authors.forename: Kyuhei
authors.initials: K
authors.lastname: Kohda
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Konuma
authors.forename: Yasuko
authors.initials: Y
authors.lastname: Hiraoka
authors.forename: Yukari
authors.initials: Y
authors.lastname: Ichikawa
authors.forename: Kaoru
authors.initials: K
authors.lastname: Ono
authors.forename: Hiroto
authors.initials: H
authors.lastname: Horiguchi
authors.forename: Ayumi
authors.initials: A
authors.lastname: Tatekoshi
authors.forename: Kouichi
authors.initials: K
authors.lastname: Takada
authors.forename: Satoshi
authors.initials: S
authors.lastname: Iyama
authors.forename: Junji
authors.initials: J
authors.lastname: Kato
mesh_terms: D000368:Aged; D055499:Catheter-Related Infections / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control*; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D002406:Catheterization, Peripheral; D062905:Central Venous Catheters; D005260:Female; D019337:Hematologic Neoplasms / Q000150:complications* / Q000188:drug therapy / Q000401:mortality; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis