Incidence of Catheter Related Bloodstream Infections After The Removal of Percutaneous Intravenous Catheters in Preterm Infants.

Abstract

The use of PICC lines in preterm infants increases the risk for systemic bacterial infections. The overall incidence of Catheter Related Bloodstream Infection (CRBSI) after PICC line removal is not well known. A single dose of antibiotics is sometimes used to try to decrease the incidence of CRBSI. Antibiotic prophylaxis to prevent CRBSI on removal of a PICC and increased use of antibiotics may increase resistant strains of bacteria. A retrospective review of medical records of infants with gestational age less than 29 completed weeks was designed. Patients were hospitalized between January 2003 and December 2003. Infants were excluded if there was death prior to PICC removal. Data for collection were prospectively identified and included total days of PICC life, days of antibiotics through PICC, days of TPN through PICC, BSI within 48 hours of PICC removal, gestational age of infants and their birthweight, method and location of PICC placement, infections noted during PICC life, sepsis evaluations within 48 hours of PICC removal, and catheter tip culture results. About 80% of babies less than 29 weeks had a PICC placed during their hospital course. 3 infants out of 72 had a CRBSI associated with a PICC. No bloodstream infections were detected within 48 hours after the removal of a PICC. No infants with a PICC had a sepsis evaluation within 48 hours of PICC removal. All infants with a PICC received total parenteral nutrition through the line. Antibiotic administration was generally remote to PICC removal, but some received antibiotics up to the removal of the PICC. Catheter tips were rarely cultured after PICC removal. PICC removal is a safe procedure without antibiotic prophylaxis, even in the face of a PICC life greater than 20 days. There is not evidence to support the administration of antibacterial prophylaxis for removal of PICC.