Affiliations: [a] Department of Pediatrics, Wheaton Franciscan Healthcare-St Joseph Hospital, Milwaukee, Wisconsin, USA
| [b] Department of Nursing, Aurora Sinai Medical Center, Milwaukee, WI, USA
| [c] Department of Nursing, Columbia St Mary’s, Milwaukee, WI, USA
| [d] Department of Nursing, Aurora West Allis Medical Center, Milwaukee, WI, USA
| [e] Department of Psychiatry, Medical College of Wisconsin, Milwaukee, WI, USA
Address for correspondence: Jeffery S. Garland, Wheaton Franciscan Healthcare St Joseph Hospital, 5000 W Chambers St, Milwaukee, WI 53210, USA. Tel.: +1 414 447 2674; Fax: +1 414 447 2884; E-mail: [email protected].
Abstract: OBJECTIVE:We hypothesized that infectious morbidities following percutaneously inserted central venous catheter (PICC) removal would be greater among neonates with central-line associated bloodstream infection (CLBASI). STUDY DESIGN:This retrospective cohort study, included all neonates who required a PICC over a ten-year period. Outcomes assessed following PICC removal included: late bloodstream infection, rule-out sepsis workups, need for a subsequent PICC and antibiotic days and PICC days after PICC removal. Odds ratios (OR) and 95% confidence intervals (CI) were determined for outcomes. Regression analyses were used to control for confounders. RESULTS:Two-thousand nine hundred and thirteen neonates required at least one PICC during the study period. After adjusting for confounders neonates with CLABSI were 3.4 (95% confidence interval (CI) 2.5, 4.6) and 2.2 (95% CI 1.2, 4.0) times more likely respectively to require a subsequent PICC or develop a late bloodstream infection after PICC removal. Neonates with CLABSI required 1.33 (95% CI 0.77, 1.89) more days of antibiotic treatment and 6.85 (95% CI 5.34, 8.37) more PICC days following PICC removal than neonates without a CLABSI. CONCLUSIONS:Neonates with CLABSI are at risk for additional infectious morbidities after PICC removal. Future intervention studies aimed at reducing CLABSI should evaluate whether morbidities following catheterization are also reduced.
Keywords: Central line associated bloodstream infection, neonate, percutaneously inserted central venous catheter, bloodstream infection