Skip to main content
Top
Published in: BMC Infectious Diseases 1/2017

Open Access 01-12-2017 | Research article

Peripheral venous catheter-related bloodstream infection is associated with severe complications and potential death: a retrospective observational study

Authors: Akihiro Sato, Itaru Nakamura, Hiroaki Fujita, Ayaka Tsukimori, Takehito Kobayashi, Shinji Fukushima, Takeshi Fujii, Tetsuya Matsumoto

Published in: BMC Infectious Diseases | Issue 1/2017

Login to get access

Abstract

Background

The purpose of this study was to identify the clinical characteristics and outcomes of peripheral vascular catheter-related bloodstream infections (PVC-BSIs) and determine the risk of severe complications or death.

Methods

We performed a retrospective observational study from June 2010 to April 2015 at two regional university-affiliated hospitals in Tokyo. We studied the clinical manifestations, underlying diseases, laboratory results, treatment methods, recurrence rates, and complications in 62 hospitalized patients diagnosed with PVC-BSIs by positive blood cultures.

Results

The median time from admission to bacteremia was 17 days (range, 3–142 days) and that from catheter insertion to bacteremia diagnosis was 6 days (range, 2–15 days). Catheter insertion sites were in the arm in 48 (77.4%) patients, in the foot in 3 (4.8%) patients, and in an unrecorded location in 11 (17.7%) patients. Additionally, the causative pathogens were Gram-positive microorganisms in 58.0% of cases, Gram-negative microorganisms in 35.8% of cases, Candida spp. in 6.2% of cases, and polymicrobials in 25.8% of cases. Eight (12.9%) patients died within 30 days of their blood culture becoming positive. Patients who died of PVC-BSIs had a higher proportion of Staphylococcus aureus infection than patients who survived (odds ratio, 8.33; p = 0.004).

Conclusions

PVC-BSIs are a significant cause of health care-associated infection. We observed cases of severe PVC-BSI requiring intensive and long-term care along with lengthy durations of antibiotic treatment due to hematogenous complications, and some patients died. For patients with PVC-BSIs, S. aureus bacteremia remains a major problem that may influence the prognosis.
Literature
2.
go back to reference Tager IB, Ginsberg MB, Ellis SE, Walsh NE, Dupont I, Simchen E, et al. An epidemiologic study of the risks associated with peripheral intravenous catheters. Am J Epidemiol. 1983;118:839–51.CrossRefPubMed Tager IB, Ginsberg MB, Ellis SE, Walsh NE, Dupont I, Simchen E, et al. An epidemiologic study of the risks associated with peripheral intravenous catheters. Am J Epidemiol. 1983;118:839–51.CrossRefPubMed
3.
go back to reference Pronovost P, Needham D, Berenholtz S, Sinopoli D, Chu H, Cosgrove S, et al. An intervention to decrease catheter-related bloodstream infections in the ICU. N Engl J Med. 2006;355:2725–32.CrossRefPubMed Pronovost P, Needham D, Berenholtz S, Sinopoli D, Chu H, Cosgrove S, et al. An intervention to decrease catheter-related bloodstream infections in the ICU. N Engl J Med. 2006;355:2725–32.CrossRefPubMed
4.
go back to reference Schulman J, Stricof R, Stevens TP, Horgan M, Gase K, Holzman IR, et al. Statewide NICU central-line-associated bloodstream infection rates decline after bundles and checklists. Pediatrics. 2011;127:436–44.CrossRefPubMed Schulman J, Stricof R, Stevens TP, Horgan M, Gase K, Holzman IR, et al. Statewide NICU central-line-associated bloodstream infection rates decline after bundles and checklists. Pediatrics. 2011;127:436–44.CrossRefPubMed
5.
go back to reference Mermel LA. Prevention of intravascular catheter-related infections. Ann Intern Med. 2000;132:391–402.CrossRefPubMed Mermel LA. Prevention of intravascular catheter-related infections. Ann Intern Med. 2000;132:391–402.CrossRefPubMed
6.
go back to reference Maki DG, Kluger DM, Crnich CJ. The risk of bloodstream infection in adults with different intravascular devices: a systematic review of 200 published prospective studies. Mayo Clin Proc. 2006;81:1159–71.CrossRefPubMed Maki DG, Kluger DM, Crnich CJ. The risk of bloodstream infection in adults with different intravascular devices: a systematic review of 200 published prospective studies. Mayo Clin Proc. 2006;81:1159–71.CrossRefPubMed
7.
go back to reference Soifer NE, Borzak S, Edlin BR, Weinstein RA. Prevention of peripheral venous catheter complications with an intravenous therapy team: a randomized controlled trial. Arch Intern Med. 1998;158:473–7.CrossRefPubMed Soifer NE, Borzak S, Edlin BR, Weinstein RA. Prevention of peripheral venous catheter complications with an intravenous therapy team: a randomized controlled trial. Arch Intern Med. 1998;158:473–7.CrossRefPubMed
8.
go back to reference Lai KK. Safety of prolonging peripheral cannula and i.V. Tubing use from 72 hours to 96 hours. Am J Infect Control. 1998;26:66–70.CrossRefPubMed Lai KK. Safety of prolonging peripheral cannula and i.V. Tubing use from 72 hours to 96 hours. Am J Infect Control. 1998;26:66–70.CrossRefPubMed
9.
go back to reference Maki DG, Ringer M. Risk factors for infusion-related phlebitis with small peripheral venous catheters. A randomized controlled trial. Ann Intern Med. 1991;114:845–54.CrossRefPubMed Maki DG, Ringer M. Risk factors for infusion-related phlebitis with small peripheral venous catheters. A randomized controlled trial. Ann Intern Med. 1991;114:845–54.CrossRefPubMed
10.
go back to reference Bregenzer T, Conen D, Sakmann P, Widmer AF. Is routine replacement of peripheral intravenous catheters necessary? Arch Intern Med. 1998;158:151–6.CrossRefPubMed Bregenzer T, Conen D, Sakmann P, Widmer AF. Is routine replacement of peripheral intravenous catheters necessary? Arch Intern Med. 1998;158:151–6.CrossRefPubMed
11.
go back to reference Collignon PJ. Intravascular catheter associated sepsis: a common problem. The Australian study on intravascular catheter associated sepsis. Med J Aust. 1994;161:374–8.PubMed Collignon PJ. Intravascular catheter associated sepsis: a common problem. The Australian study on intravascular catheter associated sepsis. Med J Aust. 1994;161:374–8.PubMed
12.
go back to reference Mermel LA, Allon M, Bouza E, Craven DE, Flynn P, O’Grady NP, et al. Clinical practice guidelines for the diagnosis and management of intravascular catheter-related infection: 2009 update by the Infectious Diseases Society of America. Clin Infect Dis. 2009;49:1–45.CrossRefPubMedPubMedCentral Mermel LA, Allon M, Bouza E, Craven DE, Flynn P, O’Grady NP, et al. Clinical practice guidelines for the diagnosis and management of intravascular catheter-related infection: 2009 update by the Infectious Diseases Society of America. Clin Infect Dis. 2009;49:1–45.CrossRefPubMedPubMedCentral
13.
go back to reference Mermel LA, Farr BM, Sherertz RJ, Raad I, O'Grady N, Harris JS, et al. Guidelines for the management of intravascular catheter-related infections. J Intraven Nurs. 2001;24:180–205.PubMed Mermel LA, Farr BM, Sherertz RJ, Raad I, O'Grady N, Harris JS, et al. Guidelines for the management of intravascular catheter-related infections. J Intraven Nurs. 2001;24:180–205.PubMed
14.
go back to reference Safdar N, Maki DG. Inflammation at the insertion site is not predictive of catheter-related bloodstream infection with short-term, noncuffed central venous catheters. Crit Care Med. 2002;30:2632–5.CrossRefPubMed Safdar N, Maki DG. Inflammation at the insertion site is not predictive of catheter-related bloodstream infection with short-term, noncuffed central venous catheters. Crit Care Med. 2002;30:2632–5.CrossRefPubMed
16.
go back to reference Fowler VG Jr, Justice A, Moore C, Benjamin DK Jr, Woods CW, Campbell S, et al. Risk factors for hematogenous complications of intravascular catheter-associated Staphylococcus Aureus bacteremia. Clin Infect Dis. 2005;40:695–703.CrossRefPubMed Fowler VG Jr, Justice A, Moore C, Benjamin DK Jr, Woods CW, Campbell S, et al. Risk factors for hematogenous complications of intravascular catheter-associated Staphylococcus Aureus bacteremia. Clin Infect Dis. 2005;40:695–703.CrossRefPubMed
17.
go back to reference Malanoski GJ, Samore MH, Pefanis A, Karchmer AW. Staphylococcus Aureus catheter-associated bacteremia. Minimal effective therapy and unusual infectious complications associated with arterial sheath catheters. Arch Intern Med. 1995;155:1161–6.CrossRefPubMed Malanoski GJ, Samore MH, Pefanis A, Karchmer AW. Staphylococcus Aureus catheter-associated bacteremia. Minimal effective therapy and unusual infectious complications associated with arterial sheath catheters. Arch Intern Med. 1995;155:1161–6.CrossRefPubMed
18.
go back to reference Fukuda H, Lee J, Imanaka Y. Costs of hospital-acquired infection and transferability of the estimates: a systematic review. Infection. 2011;39:185–99.CrossRefPubMed Fukuda H, Lee J, Imanaka Y. Costs of hospital-acquired infection and transferability of the estimates: a systematic review. Infection. 2011;39:185–99.CrossRefPubMed
19.
go back to reference Nakamura I, Fukushima S, Hayakawa T, Sekiya K, Matsumoto T. The additional costs of catheter-related bloodstream infections in intensive care units. Am J Infect Control. 2015;43:1046–9.CrossRefPubMed Nakamura I, Fukushima S, Hayakawa T, Sekiya K, Matsumoto T. The additional costs of catheter-related bloodstream infections in intensive care units. Am J Infect Control. 2015;43:1046–9.CrossRefPubMed
20.
go back to reference Pujol M, Hornero A, Saballs M, Argerich MJ, Verdaguer R, Cisnal M, et al. Clinical epidemiology and outcomes of peripheral venous catheter-related bloodstream infections at a university-affiliated hospital. J Hosp Infect. 2007;67:22–9.CrossRefPubMed Pujol M, Hornero A, Saballs M, Argerich MJ, Verdaguer R, Cisnal M, et al. Clinical epidemiology and outcomes of peripheral venous catheter-related bloodstream infections at a university-affiliated hospital. J Hosp Infect. 2007;67:22–9.CrossRefPubMed
21.
go back to reference Wyllie DH, Crook DW, Peto TE. Mortality after Staphylococcus Aureus bacteraemia in two hospitals in Oxfordshire, 1997-2003: cohort study. BMJ. 2006;333:281.CrossRefPubMedPubMedCentral Wyllie DH, Crook DW, Peto TE. Mortality after Staphylococcus Aureus bacteraemia in two hospitals in Oxfordshire, 1997-2003: cohort study. BMJ. 2006;333:281.CrossRefPubMedPubMedCentral
Metadata
Title
Peripheral venous catheter-related bloodstream infection is associated with severe complications and potential death: a retrospective observational study
Authors
Akihiro Sato
Itaru Nakamura
Hiroaki Fujita
Ayaka Tsukimori
Takehito Kobayashi
Shinji Fukushima
Takeshi Fujii
Tetsuya Matsumoto
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Infectious Diseases / Issue 1/2017
Electronic ISSN: 1471-2334
DOI
https://doi.org/10.1186/s12879-017-2536-0

Other articles of this Issue 1/2017

BMC Infectious Diseases 1/2017 Go to the issue