Platanaki Christina, Zareifopoulos Nicholas, Lagadinou Maria, Tsiotsios Konstantinos, Velissaris Dimitrios
Department of Internal Medicine, General University Hospital of Patras, Patras, GRC.
Cureus. 2021 Jan 22;13(1):e12858. doi: 10.7759/cureus.12858.
The use of peripherally inserted central catheter (PICC) lines offers several advantages compared to traditional central venous catheters (CVCs) as the insertion procedure is minimally invasive, they may be retained safely for longer periods of time, and their use is associated with fewer catheter-related infections. Their use in patients suffering from a malignant disease is common but may pose a greater risk of complications due to the severe immunosuppression associated with treatment. This study was conducted to evaluate the safety of PICC lines in this group.
This was a retrospective study of oncology patients being treated in a Mediterranean tertiary center. Patients with PICC lines were enrolled in the study if a positive blood culture necessitated the removal of the PICC and subsequent culture of the PICC tip. A comparison was conducted between patients with positive and negative PICC cultures.
Thirty patients were included, four of whom had a positive PICC culture. The most commonly isolated pathogens were coagulase-negative Staphylococci and Corynebacteria. No statistically significant difference was noted in white blood cell (WBC) counts, C-reactive protein (CRP), and Michigan PICC central line associated bloodstream infection (MPC) score between the two groups. Staphylococcus epidermidis was the most commonly isolated pathogen.
Though limited by a small sample size and the retrospective design, the findings of this study seem to corroborate existing literature on the subject which suggests that the use of PICC lines in oncology patients is feasible and does not pose unacceptable risk. Further research is indicated to determine subgroups which may be at greater risk of PICC related infections.
与传统中心静脉导管(CVC)相比,使用外周静脉穿刺中心静脉导管(PICC)具有多个优势,因为其置管过程微创,可安全留置更长时间,且使用时导管相关感染较少。PICC在恶性疾病患者中应用广泛,但由于治疗相关的严重免疫抑制,可能带来更高的并发症风险。本研究旨在评估PICC在该组患者中的安全性。
这是一项对地中海地区一家三级中心接受治疗的肿瘤患者的回顾性研究。如果血培养阳性需要拔除PICC并随后对PICC尖端进行培养,则将留置PICC的患者纳入研究。对PICC培养阳性和阴性的患者进行了比较。
共纳入30例患者,其中4例PICC培养阳性。最常分离出的病原体是凝固酶阴性葡萄球菌和棒状杆菌。两组之间白细胞(WBC)计数、C反应蛋白(CRP)和密歇根PICC中心静脉导管相关血流感染(MPC)评分无统计学显著差异。表皮葡萄球菌是最常分离出的病原体。
尽管本研究受样本量小和回顾性设计的限制,但其结果似乎证实了关于该主题的现有文献,即PICC在肿瘤患者中的使用是可行的,且不会带来不可接受的风险。需要进一步研究以确定可能有更高PICC相关感染风险的亚组。