title: Risk of Infection Using Peripherally Inserted Central and Umbilical Catheters in Preterm Neonates.
abstract: OBJECTIVE
  To compare the rates of catheter-associated bloodstream infection (CABSI) in preterm infants born at <30 weeks' gestation who received a peripherally inserted central catheter (PICC) versus an umbilical venous catheter (UVC) immediately after birth as their primary venous access.
  
  
  METHODS
  This retrospective matched cohort study examined data from infants born at <30 weeks' gestation and admitted between January 2010 and December 2013 to neonatal units in the Canadian Neonatal Network. Eligible infants who received a PICC on the first day after birth (day 1) were matched with 2 additional groups of infants, those who received a UVC on day 1 and those who received a UVC on day 1 that was then changed for a PICC after 4 days or more. The primary outcome was number of infants with CABSI per 1000 catheter days, which was compared between the 3 groups using multivariable analyses.
  
  
  RESULTS
  Data from 540 eligible infants were reviewed (180 per group). There was no significant difference in infants with CABSI/1000 catheter days between the 3 groups (9.3 vs 7.8 vs 8.2/1000 catheter days, respectively; P > .05) despite lower rates of late onset sepsis in the group of infants who received only a UVC.
  
  
  CONCLUSIONS
  There was no significant difference in the incidence of CABSI between very preterm neonates who received a PICC, UVC, or UVC followed by PICC as the primary mode of venous access after birth. A prospective randomized controlled trial is justified to further guide practice regarding primary venous access and reduction of infection.
authors.affiliation: Department of Paediatrics, and.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Shalabi
authors.affiliation: Department of Paediatrics, and.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Adel
authors.affiliation: Department of Paediatrics, and.
authors.forename: Eugene
authors.initials: E
authors.lastname: Yoon
authors.affiliation: Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Khalid
authors.initials: K
authors.lastname: Aziz
authors.affiliation: Department of Paediatrics, and Maternal-Infant Care Research Centre, Mount Sinai Hospital, Toronto, Ontario, Canada; and.
authors.forename: Shoo
authors.initials: S
authors.lastname: Lee
authors.affiliation: Department of Paediatrics, and Maternal-Infant Care Research Centre, Mount Sinai Hospital, Toronto, Ontario, Canada; and pshah@mtsinai.on.ca.
authors.forename: Prakesh S
authors.initials: PS
authors.lastname: Shah
mesh_terms: D002170:Canada / Q000453:epidemiology; D055499:Catheter-Related Infections / Q000453:epidemiology*; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D002406:Catheterization, Peripheral / Q000009:adverse effects*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D007234:Infant, Premature; D007363:Intensive Care Units, Neonatal; D008297:Male; D012189:Retrospective Studies; D012306:Risk; D018805:Sepsis / Q000453:epidemiology* / Q000209:etiology; D014471:Umbilical Veins