Peripherally inserted central venous catheters decrease central line-associated bloodstream infections and change microbiological epidemiology in adult hematology unit: a propensity score-adjusted analysis (Jul, 10.1007/s00277-022-04908-6, 2022)

被引：3

作者：

Nakaya, Yosuke ^{[1
,2
]}

Imasaki, Mika ^{[3
]}

Shirano, Michinori ^{[3
]}

Shimizu, Katsujun ^{[1
]}

Yagi, Naoko ^{[1
]}

Tsutsumi, Minako ^{[1
,2
]}

Yoshida, Masahiro ^{[1
]}

Yoshimura, Takuro ^{[1
]}

Hayashi, Yoshiki ^{[1
]}

Nakao, Takafumi ^{[1
]}

Yamane, Takahisa ^{[1
]}

机构：

[1] Osaka City Gen Hosp, Dept Hematol, 2 13 22 Miyakojima hondori Miyakojima Ku, Osaka, Osaka 5340021, Japan

[2] Osaka Metropolitan Univ, Grad Sch Med, Dept Hematol, 1 4 3 Asahi machi Abeno Ku, Osaka, Osaka 5458585, Japan

[3] Osaka City Gen Hosp, Dept Infect Dis, 2 13 22 Miyakojima hondori Miyakojima Ku, Osaka, Osaka 5340021, Japan

来源：

ANNALS OF HEMATOLOGY | 2022年 / 101卷 / 09期

关键词：

Central line-associated bloodstream infection; Corynebacterium; Hematological disorder; Inverse probability of treatment weighting; Peripherally inserted central venous catheter; Propensity score;

D O I：

10.1007/s00277-022-04927-3

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Peripherally inserted central venous catheters (PICCs) have a potential advantage in preventing central line-associated bloodstream infection (CLABSI) compared with the centrally inserted ones (CICCs). However, due to a limited number of studies with insufficient statistical evaluation, the superiority of PICCs is difficult to be generalized in adult hematology unit. We conducted a single-center retrospective study and compared the risk of CLABSI between 472 CICCs and 557 PICCs inserted in adult patients with hematological disorders through conventional multivariate models and a propensity score-adjusted analysis. The overall CLABSI incidence in CICCs and PICCs was 5.11 and 3.29 per 1000 catheter days (P = 0.024). The multivariate Cox regression analysis (hazard ratio [HR]: 0.48; 95% confidence interval [CI]: 0.31–0.75; P = 0.001) and Fine-Gray subdistribution analysis (HR: 0.59; 95% CI: 0.37–0.93; P = 0.023) demonstrated that PICC was independently associated with a reduced risk of CLABSI. Moreover, the stabilized inverse probability of treatment weighting analysis, which further reduced the selection bias between CICCs and PICCs, showed that PICCs significantly prevented CLABSI (HR: 0.58; 95% CI: 0.35–0.94; P = 0.029). Microbiologically, PICCs showed a significant decrease in gram-positive cocci (P = 0.001) and an increase in gram-positive bacilli (P = 0.002) because of a remarkable reduction in Staphylococci and increase in Corynebacterium species responsible for CLABSI. Our study confirmed that PICC was a superior alternative to CICC in preventing CLABSI in the adult hematology unit, while it posed a microbiological shift in local epidemiology. © 2022, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

引用

页码：2079 / 2079

页数：1