Is it Safe to Place a Peripherally Inserted Central Catheter Line in Patientswith Bacteremia? A Retrospective Cohort Study at a Single Institution

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The use of peripherally inserted central catheter (PICC) lines has steadily grown in hospital settings. Approximately 8% of patients in critical care settings require central venous access during their hospital stay. Peripherally inserted central catheter lines provide several advantages over classical central venous catheters (CVCs): insertion safety, removal safety, and cost-effectiveness. Moreover, a PICC line serves as a multipurpose device, it has an increased dwell time, and it obviates the need for frequent cannulation. Indications, contraindications, and potential complications must be considered prior to the insertion of a PICC line. The most common indications for PICC line use include frequent blood sampling and the need to deliver blood components, parenteral nutrition, or treatments considered to be vesicants or irritating (e.g., chemotherapy or antibiotics). Contraindications for the use of PICC lines include overt sepsis, bacteraemia, skin infections, and burns. Of all PICC line complications associated with increased morbidity, infections and vein thrombosis are the most important. Depending one patient’s health, these complications may even increase mortality rates. According to the Centres for Disease Control and Prevention (CDC), blood stream infections (BSIs) can be defined as the presence of viable bacteria in the blood (i.e., bacteraemia). Documented by a positive blood culture result. In 2019, Krein conducted a multicentre prospective cohort study of the 70-day follow-up period of 438 patients who had received a PICC line. Over half (61.4%) of the patients reported signs of at least one potentially serious complication such as a BSI (17.6%) or deep vein thrombosis (30.6%). We have demonstrated statistically significant risks of BSIs during and after the removal of PICC lines; these risks are associated with increased dwell times of the PICC lines, increased hospital LOS, and non-Saudi nationality. Positive blood cultures during or after the removal of PICC lines were not significantly dependent on prior positive cultures. We recommend the removal or exchange of a PICC line if one is needed for more than one month. We also suggest decreasing the hospitalization period to less than three months, if possible, and using more effective ways to communicate with non-Saudi patients. Ultimately, policies delaying PICC line insertion inpatients with bacteremia should be reconsidered. Media contact: Sarah V Managing Editor Journal of Infectious Diseases & Therapy Email: Jidt@eclinicalsci.com What’s App: +1-947-333-4405