title: Catheter-associated bloodstream infections and thrombotic risk in hematologic patients with peripherally inserted central catheters (PICC).
abstract: OBJECTIVE
  The use of peripherally inserted central catheters (PICC) as an alternative to other central venous access devices (CVAD) is becoming very frequent in cancer patients. To evaluate the impact of complications associated to these devices in patients with hematologic malignancies, we revised the catheter-related bloodstream infections (CRBSI) and the catheter-related thrombotic complications (CRTC) observed at our institute between January 2009 and December 2012.
  
  
  METHODS
  A total of 612 PICCs were inserted into 483 patients at diagnosis or in subsequent phases of their hematologic disease. PICCs were successfully inserted in all cases. The median duration of in situ PICC placement was 101 days (interquartile range, 48-184 days).
  
  
  RESULTS
  A CRBSI occurred in 47 cases (7.7 %), with a rate of 0.59 per 1000 PICC days. A CRTC was recorded in 16 cases (2.6 %), with a rate of 0.20 per 1000 PICC days. No serious complication was associated to these events. Cox regression analyses of variables associated to CRBSIs and to CRTCs showed that only the type of disease (acute leukemia compared to other diseases) was significantly associated to a higher incidence of CRBSIs, while no feature was predictive for a higher risk of CRTCs.
  
  
  CONCLUSIONS
  PICCs represent a useful and safe alternative to conventional CVAD for the management of patients with hematologic malignancies.
authors.affiliation: Dipartimento di Biotecnologie Cellulari ed Ematologia, Policlinico Umberto I, "Sapienza" University of Rome, Via Benevento 6, 00161, Rome, Italy. morano@bce.uniroma1.it.
authors.forename: Salvatore Giacomo
authors.initials: SG
authors.lastname: Morano
authors.affiliation: Dipartimento di Biotecnologie Cellulari ed Ematologia, Policlinico Umberto I, "Sapienza" University of Rome, Via Benevento 6, 00161, Rome, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Latagliata
authors.affiliation: Dipartimento di Biotecnologie Cellulari ed Ematologia, Policlinico Umberto I, "Sapienza" University of Rome, Via Benevento 6, 00161, Rome, Italy.
authors.forename: Corrado
authors.initials: C
authors.lastname: Girmenia
authors.affiliation: Dipartimento di Biotecnologie Cellulari ed Ematologia, Policlinico Umberto I, "Sapienza" University of Rome, Via Benevento 6, 00161, Rome, Italy.
authors.forename: Fulvio
authors.initials: F
authors.lastname: Massaro
authors.affiliation: Dipartimento di Biotecnologie Cellulari ed Ematologia, Policlinico Umberto I, "Sapienza" University of Rome, Via Benevento 6, 00161, Rome, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Berneschi
authors.affiliation: Dipartimento di Biotecnologie Cellulari ed Ematologia, Policlinico Umberto I, "Sapienza" University of Rome, Via Benevento 6, 00161, Rome, Italy.
authors.forename: Alfonso
authors.initials: A
authors.lastname: Guerriero
authors.affiliation: Dipartimento di Biotecnologie Cellulari ed Ematologia, Policlinico Umberto I, "Sapienza" University of Rome, Via Benevento 6, 00161, Rome, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Giampaoletti
authors.affiliation: Dipartimento di Biotecnologie Cellulari ed Ematologia, Policlinico Umberto I, "Sapienza" University of Rome, Via Benevento 6, 00161, Rome, Italy.
authors.forename: Arianna
authors.initials: A
authors.lastname: Sammarco
authors.affiliation: Dipartimento di Biotecnologie Cellulari ed Ematologia, Policlinico Umberto I, "Sapienza" University of Rome, Via Benevento 6, 00161, Rome, Italy.
authors.forename: Giorgia
authors.initials: G
authors.lastname: Annechini
authors.affiliation: Dipartimento di Biotecnologie Cellulari ed Ematologia, Policlinico Umberto I, "Sapienza" University of Rome, Via Benevento 6, 00161, Rome, Italy.
authors.forename: Angelo
authors.initials: A
authors.lastname: Fama
authors.affiliation: Dipartimento di Biotecnologie Cellulari ed Ematologia, Policlinico Umberto I, "Sapienza" University of Rome, Via Benevento 6, 00161, Rome, Italy.
authors.forename: Alice
authors.initials: A
authors.lastname: Di Rocco
authors.affiliation: Dipartimento di Biotecnologie Cellulari ed Ematologia, Policlinico Umberto I, "Sapienza" University of Rome, Via Benevento 6, 00161, Rome, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Chistolini
authors.affiliation: Dipartimento di Biotecnologie Cellulari ed Ematologia, Policlinico Umberto I, "Sapienza" University of Rome, Via Benevento 6, 00161, Rome, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Micozzi
authors.affiliation: Dipartimento di Biotecnologie Cellulari ed Ematologia, Policlinico Umberto I, "Sapienza" University of Rome, Via Benevento 6, 00161, Rome, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Molica
authors.affiliation: Dipartimento di Biotecnologie Cellulari ed Ematologia, Policlinico Umberto I, "Sapienza" University of Rome, Via Benevento 6, 00161, Rome, Italy.
authors.forename: Walter
authors.initials: W
authors.lastname: Barberi
authors.affiliation: Dipartimento di Biotecnologie Cellulari ed Ematologia, Policlinico Umberto I, "Sapienza" University of Rome, Via Benevento 6, 00161, Rome, Italy.
authors.forename: Clara
authors.initials: C
authors.lastname: Minotti
authors.affiliation: Dipartimento di Biotecnologie Cellulari ed Ematologia, Policlinico Umberto I, "Sapienza" University of Rome, Via Benevento 6, 00161, Rome, Italy.
authors.forename: Gregorio Antonio
authors.initials: GA
authors.lastname: Brunetti
authors.affiliation: Dipartimento di Biotecnologie Cellulari ed Ematologia, Policlinico Umberto I, "Sapienza" University of Rome, Via Benevento 6, 00161, Rome, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Breccia
authors.affiliation: Dipartimento di Biotecnologie Cellulari ed Ematologia, Policlinico Umberto I, "Sapienza" University of Rome, Via Benevento 6, 00161, Rome, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Cartoni
authors.affiliation: Dipartimento di Biotecnologie Cellulari ed Ematologia, Policlinico Umberto I, "Sapienza" University of Rome, Via Benevento 6, 00161, Rome, Italy.
authors.forename: Saveria
authors.initials: S
authors.lastname: Capria
authors.affiliation: Dipartimento di Anestesiologia e Terapia Intensiva, Policlinico Umberto I, "Sapienza" University of Rome, Rome, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Rosa
authors.affiliation: Dipartimento di Biotecnologie Cellulari ed Ematologia, Policlinico Umberto I, "Sapienza" University of Rome, Via Benevento 6, 00161, Rome, Italy.
authors.forename: Giuliana
authors.initials: G
authors.lastname: Alimena
authors.affiliation: Dipartimento di Biotecnologie Cellulari ed Ematologia, Policlinico Umberto I, "Sapienza" University of Rome, Via Benevento 6, 00161, Rome, Italy.
authors.forename: Robin
authors.initials: R
authors.lastname: Foà
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D016470:Bacteremia / Q000150:complications / Q000382:microbiology*; D055499:Catheter-Related Infections / Q000453:epidemiology / Q000382:microbiology*; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D002406:Catheterization, Peripheral / Q000009:adverse effects*; D005260:Female; D019337:Hematologic Neoplasms / Q000150:complications / Q000628:therapy; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D013927:Thrombosis / Q000453:epidemiology* / Q000209:etiology
keywords: Hematologic malignancies; Infections; PICC; Thrombosis