Peripherally Inserted Central Venous Catheter-Associated Bloodstream Infections in Hospitalized Adult Patients
Peripherally Inserted Central Venous Catheter-Associated Bloodstream Infections in Hospitalized Adult Patients
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DOI：
10.1086/657942
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发表时间：
2011-02-01
影响因子：
4.5
通讯作者：
Warren, David K.
中科院分区：
文献类型：
--
作者：
Cristina Ajenjo, M.;Morley, James C.;Warren, David K.
背景关于住院患者外周插入中心静脉导管相关血流感染（PICC BSI）风险的数据有限。在2007年，专门的静脉治疗护士不再提供放置困难的外周静脉导管或提供PICC护理巴恩斯犹太医院。确定全医院范围内PICC BSI的发生率，并评估中断静脉治疗服务对PICC使用和PICC BSI率的影响。一家拥有1，252张床位的三级护理教学医院。进行了一项为期31个月的回顾性队列研究。使用国家医疗保健安全网络标准定义PICC BSI。共识别出163例PICC BSI（每1,000导管日3.13例BSI）。重症监护室（ICU）的PICC使用率高于非ICU区域（ICU与非ICU的PICC使用率为0.109 vs 0.059导管-天/患者-天;率比[RR]，1.84 [95%置信区间{CI}，1.78-1.91]）。ICU的PICC BSI发生率更高（4.79 vs 2.79发作/1,000导管日; RR，1.7 [95% CI，1.10-2.61]）。静脉治疗服务停止后，PICC的使用在全院范围内增加（0.049 vs 0.097导管日/患者日; P = 0.01），但PICC BSI发生率没有变化（2.68 vs 3.63发作/1,000导管日; P = 0.01）。06）。在PICC BSI中，73%发生在非ICU患者中。ICU的PICC使用率和PICC BSI发生率较高;然而，大多数PICC BSI发生在非ICU区域。静脉治疗服务的减少与全院PICC使用的增加有关，但PICC BSI发生率并未增加。感染控制医院流行病学2011; 32（2）：125-130
BACKGROUND. Limited data on the risk of peripherally inserted central venous catheter-associated bloodstream infections (PICC BSIs) in hospitalized patients are available. In 2007, dedicated intravenous therapy nurses were no longer available to place difficult peripheral intravenous catheters or provide PICC care Barnes-Jewish Hospital.OBJECTIVES. To determine the hospital-wide incidence of PICC BSIs and to assess the effect of discontinuing intravenous therapy service on PICC use and PICC BSI rates.SETTING. A 1,252-bed tertiary care teaching hospital.METHODS. A 31-month retrospective cohort study was performed. PICC BSIs were defined using National Healthcare Safety Network criteria.RESULTS. In total, 163 PICC BSIs were identified (3.13 BSIs per 1,000 catheter-days). PICC use was higher in intensive care units (ICUs) than non-ICU areas (PICC utilization ratio, 0.109 vs 0.059 catheter-days per patient-day for ICU vs non-ICU; rate ratio [RR], 1.84 [95% confidence interval {CI}, 1.78-1.91]). PICC BSI rates were higher in ICUs (4.79 vs 2.79 episodes per 1,000 catheter-days; RR, 1.7 [95% CI, 1.10-2.61]). PICC use increased hospital-wide after the intravenous therapy service was discontinued (0.049 vs 0.097 catheter-days per patient-day; P = .01 ), but PICC BSI rates did not change (2.68 vs 3.63 episodes per 1,000 catheter-days; Pp. 06). Of PICC BSIs, 73% occurred in non-ICU patients.CONCLUSIONS. PICC use and PICC BSI rates were higher in ICUs; however, most of the PICC BSIs occurred in non-ICU areas. Reduction in intravenous therapy services was associated with increased PICC use across the hospital, but PICC BSI rates did not increase. Infect Control Hosp Epidemiol 2011; 32(2): 125-130