Risk of catheter-related bloodstream infection and thrombosis in patients with peripherally inserted central catheter

Abstract

Objective To study the risk of catheter-related bloodstream infection and thrombosis in patients with peripherally inserted central catheter (PICC). Methods The patients taking PICC catheterization at our hospital from January, 2017 to May, 2018 were selected. The patients with PICC catheterization infection for the first time during the process of PICC catheterization were randomly selected as an infection group. The patients without bloodstream infection were matched at a ratio of 1:3 in terms of sex, catheterization time, and age, and were set as a control group. The clinical data of the two groups were collected and the risk factors of PICC catheter-related bloodstream infection and thrombosis in the patients with hematological diseases were retrospectively analyzed. The conditional logistic regression model of 1:3 pairing was used for multivariate analysis. Results There were 3 cases of pulmonary infection and 5 cases of pulmonary infection in the infection group and the control group, respectively, with a statistical significance (P 0.05). There were 11 cases of heart insufficiency in the infection group and 2 cases in the control group (P 0.05). There were 4 cases of hepatic insufficiency in the infection group and 4 cases in the control group (P>0.05). Multivariate analysis showed that acute leukemia [P=0.021, OR value 2.021, OR value 95% CI (1.245, 3.639)], the times of catheterization [P<0.01, OR value 1.886, OR value 95% CI (1.557, 2.276)], the duration of granular deficiency [P=0.001, OR value 1.025, the OR value 95% CI (1.011, 1.038)], and the lowest albumin value [P<0.01, OR value 0.937, OR value 95% CI (0.917, 0.959)]. The analysis of bacterial strains in the patients with hematological diseases showed that G+ bacteria was the main local infection associated with PICC catheter. G- bacteria was the main pathogens of PICC catheter-related bloodstream infections. Conclusion The duration of granular deficiency, the times of catheterization, and the lowest albumin level during treatment are risk factors for PICC catheter bloodstream infection and thrombosis. Antibiotics covered with G- bacteria and fungi have to be used to treat PICC catheter-related bloodstream infections and thrombosis in patients with hematological diseases. Key words: Hematological diseases; PICC; Catheter-related infections; Thrombosis; Risk factors