Central line-associated bloodstream infections, differences between peripherally inserted central catheters versus Long-term central venous catheters in haemato-oncological patients

The incidence of Central Line Associated Blood Stream Infections (CLABSIs) varies considerably by type of catheter, manipulation and patient-related factors The type of catheter is related with a different risk of infectious complications.
Our primary outcome was to compare the risk for CLABSIs and Catheter Related Blood Stream Infection (CRBSIs) in PICCs versus long-term CVCs.
CLABSIs were identified when a laboratory-confirmed bloodstream infection occurs and a central line was in place for >2 calendar days on the date of event, and no signs of infection in another site [6].
Multivariate analysis was performed using logistic regressions. The incidence of catheter-related infections was calculated using the denominator “per 1000 catheter days”.
The insertions of PICCs were significantly increased compared with other catheters, raising from 67,8% to 86,0% of all insertions (p = 0,032)
On bivariate analysis PORTs and t-CVCs were associated with the onset of infections, either CLABSIs and CRBSIs (p = 0,001). A significant decrease during the study period could be observed only for CLABSIs (p
= 0,017).
Multivariate analysis confirmed the protective role of PICCs in catheter related-infections, with PORTs remaining significantly associated with CLABSIs (OR 1,88; 95% p = 0,011) and t-CVCs with CRBSI
(OR 2,38; p = 0,019).
In conclusion, PICCs represent, due to their lowest rate of CLABSIs and CRBSIs, the best central venous access in cancer patients.

Antonella Santoro
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