Previous peripherally inserted central catheter (PICC) placement as a risk factor for PICC-associated bloodstream infections

Background: Peripherally inserted central catheter (PICC) -associated bloodstream infection (BSI) is a concern.

Methods: A case-control study was conducted to assess risk factors for PICC-associated BSI.

Results: A total of 1,215 cases and 31,874 catheter days were analyzed. In total, 54 cases of PICC-associated BSI were detected giving an infection rate of 1.69 per 1,000 catheter-days. The most frequently isolated pathogens were coagulase-negative staphylococci (26%), followed by Enterococcus species (22%), Candida species (17%), and Staphylococcus aureus (11%). Multivariable analysis identified the significant risk factors for PICC-associated BSI as a prior PICC placement (odds ratio [OR], 2.48; 95% confidence interval [CI], 1.36-4.53), medical department admission (OR, 1.89; 95% CI, 1.03-3.46), and older age (OR, 1.03; 95% CI, 1.00-1.05). With increasing frequency of previous PICC placement, the rates of PICC-associated BSI increased: 3.5% (31/883) without previous placement, 7.6% (13/171) in once, and 9.9% (9/32) in twice or more.

Discussion: The previous PICC placement was an independent risk factor for PICC-associated BSI and the risk proportionally rose with the increasing frequency of prior PICC placement.

Conclusions: Patients with repeatedly inserted PICC should be managed more carefully for prevention and should be monitored for the development of PICC-associated BSI.