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Abstract
The study was aimed to investigate the pathogens distribution and risk factors for PICC-related bloodstream infection in intensive care unit (ICU) patients. 402 patients placed with PICC in ICU were recruited in the study. The microbiological characteristics of PICC-related infection were investigated by Vitek 2 Compact automated microbial system. Antibiotics sensitivity was performed with disk diffusion and minimum inhibitory concentration (MIC) methods. Multivariate logistic and cox analyses were performed to identify the risk factors for PICC-related infection in ICU patients. 38 PICC-related infection cases were observed, and its morbidity was 9.45%. The morbidity was significantly higher in power PICC cases than that in common PICC cases. Gram-positive bacteria might be responsible for the major infection cases, followed by gram-negative bacteria, and fungi. Drug sensitivity analyses indicated that gram-negative bacteria showed low resistance to carbapenems antibiotics, and Cefperazone/sulbactam. The gram-positive bacterial exhibited sensitive to Teicoplanin and Vancomycin. The isolated fungi showed low resistance to the commonly used antifungal antibiotics. Multivariate analyses demonstrated that power PICC, high Charison scores, diabetes mellitus, double lumens triple lumens were risk factors for PICC-related infections among ICU patients. Power PICC, high Charison scores, diabetes mellitus, multi-lumens are risk factors for PICC-related bloodstream infection in ICU patients.
Highlights
Central venous catheters (CVCs) are widely used in clinical setting due to their functional roles in intravenous treatments, laboratory testing, and hemodynamic monitoring[1]
167 (41.54%) of them were diagnosed with hypertension, 171 (42.54%) patients were combined with diabetes mellitus, and malignancy cases accounted for 43.03%
The application of Peripherally inserted central catheter (PICC) is prevalent in intensive care unit (ICU) setting
Summary
Central venous catheters (CVCs) are widely used in clinical setting due to their functional roles in intravenous treatments, laboratory testing, and hemodynamic monitoring[1]. Inserted central catheter (PICC), a specialized CVC, play an important role in treatment of hospitalized patients, especially intensive care unit (ICU) patients[2]. Power PICC can meet the requirements for high flow rate of intravenous infusion, and multiple-lumen catheters which are common need among patients in ICU ward[6]. Despite the various advantages of PICC for ICU patients, PICC shows some complications, including catheter-related thrombophlebitis, and bloodstream infection[7]. To improve the management of PICC-related bloodstream infection, various researches were designed to identify the risk factors for infection among patients placed with PICC. We aimed to investigate the basic characteristics of PICC-related bloodstream infections in ICU patients. In order to guide the empirical antibiotic application, the microbiological characteristics of PICC-related bloodstream infection was investigated, as well the drug sensitivity analysis
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