Department of Pediatrics, University of Texas Medical Branch, Galveston, Texas.
Division of Neonatology, Department of Pediatrics, Children's Mercy, Kansas City, Missouri.
Am J Perinatol. 2018 Aug;35(10):990-993. doi: 10.1055/s-0038-1632391. Epub 2018 Feb 23.
Peripherally inserted central catheter (PICC) line removal is associated with bloodstream infections and clinical sepsis. We aim to investigate the role of a single prophylactic dose of vancomycin in decreasing the incidence of central line associated bloodstream infection associated with PICC removal.
A retrospective chart review of patients in the neonatal intensive care unit was conducted. Patients were divided into two study groups based on whether a single dose of vancomycin was administered (exposed) or not (nonexposed). The primary outcome measured was clinical sepsis with or without positive blood culture.
The incidence of clinical sepsis in the exposed group was 7.3% compared with 6.3% in the nonexposed group (-value: 0.7860). The incidence of culture-positive sepsis in the exposed group was 2.2% compared with 1.6% in the nonexposed group (-value: 0.7673). The overall incidence of clinical and culture-positive sepsis in the subgroup with infants weighing <1,500 g and <32 weeks' gestational age was similar to the main study group.
Our data do not support routine vancomycin prophylaxis prior to PICC line removal in premature infants to prevent sepsis associated with PICC removal. However, a large randomized controlled trial is further needed to delineate these results.
外周静脉置入中心静脉导管（PICC）置管后移除与血流感染和临床败血症有关。我们旨在研究单次预防性万古霉素剂量是否能降低与 PICC 移除相关的中心静脉相关血流感染的发生率。
对新生儿重症监护病房的患者进行了回顾性图表审查。根据是否给予单次万古霉素剂量（暴露组）或未给予（未暴露组），将患者分为两组研究。主要测量的结果是有或无阳性血培养的临床败血症。
暴露组的临床败血症发生率为 7.3%，而未暴露组为 6.3%（-值：0.7860）。暴露组培养阳性败血症的发生率为 2.2%，而未暴露组为 1.6%（-值：0.7673）。在体重<1,500g 和<32 周胎龄的婴儿亚组中，临床和培养阳性败血症的总体发生率与主要研究组相似。
我们的数据不支持在早产儿中常规在 PICC 置管前预防性使用万古霉素来预防与 PICC 移除相关的败血症。然而，还需要进一步进行大规模的随机对照试验来阐明这些结果。
