Do Prolonged Peripherally Inserted Central Venous Catheter Dwell Times Increase the Risk of Bloodstream Infection?

Abstract

From the Department of Pediatrics, Division of Pediatric Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland (all authors). Received April 6, 2010; accepted May 17, 2010; electronically published October 1, 2010. Infect Control Hosp Epidemiol 2010; 31(11):1184-1187 2010 by The Society for Healthcare Epidemiology of America. All rights reserved. 0899-823X/2010/3111-0013$15.00. DOI: 10.1086/656589 Peripherally inserted central venous catheters (PICCs) have become increasingly popular as a result of the ease of their placement at the bedside and their long-term viability with relatively minimal mechanical complications. Although PICCs were initially intended for short-term vascular access, these catheters often remain in place for weeks to months. No prospective trials have evaluated whether replacement of central venous catheters (CVCs) beyond 7 days after insertion can reduce rates of central line–associated bloodstream infection (CLABSI). Similarly, no prospective trials have evaluated whether scheduled replacement of PICCs can reduce incidence of CLABSI. In this commentary, we discuss why longer catheter dwell times may increase the risk of CLABSI at an accelerated pace in patients with PICCs and why, in some instances, PICC replacement or an alternative intervention may prevent CLABSI.