Peripheral intravenous catheter‐associated Staphylococcus aureus bacteraemia: more than 5 years of prospective data from two tertiary health services

Abstract

To determine the incidence, risk factors for and outcomes of Staphylococcus aureus bacteraemia (SAB) associated with peripheral intravenous catheters (PIVCs). A review of prospectively collected data from two tertiary health services on all health care-associated SAB episodes occurring in adults aged >172013s from January 2007to July 2012. Numbers of health care-associated SAB episodes; device type, location of insertion, device dwell time and outcome at 7and 30days for all SAB episodes associated with use of a PIVC; rates of SAB per 10000occupied bed-days (OBDs). Overall, 137of 583health care-associated-SAB episodes (23.5%) were deemed to be PIVC associated, with an incidence of 0.26/10000OBD. The mean dwell time for PIVCs was 3.5days (range, 0.25-9days) and 45.2% of SABs occurred in PIVCs with a dwell time ≥4days. Of the PIVC-associated SAB episodes, 39.6% involved PIVCs inserted in the ED, 39.6% involved PIVCs inserted on wards and 20.8% involved PIVCs inserted by the ambulance service. Of the PIVC-associated SABs occurring within 4days of insertion, 61% were inserted by ED staff or the ambulance service. PIVC-associated SAB were associated with a 30-day all-cause mortality rate of 26.5%. PIVC-associated SAB is an under-recognised complication. The high incidences of SAB associated with PIVCs inserted in emergency locations and with prolonged dwell times support recommendations in clinical guidelines for routine removal of PIVCs.