The First Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China.
Department of Hematology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China.
Am J Infect Control. 2022 Oct;50(10):1171-1177. doi: 10.1016/j.ajic.2022.01.016. Epub 2022 Jan 30.
We sought to investigate the nature and incidence of bloodstream infection complications and to identify the risk factors of central catheter-related bloodstream infections (CRBSI).
During the study period, 291 consecutive patients with hematological malignancies who underwent PICC placement were retrospectively enrolled. We analyzed the covariates that were specified a priori for their association with CRBSI through multivariate Cox proportional hazards regression models. The association between each predictor and the related outcome was expressed using hazard ratios (HRs) with corresponding 95% confidence intervals (CIs).
Of 391 peripherally inserted central catheter (PICCs) were inserted in 291 patients for a total of 63,714 catheter days during 7 years, with an infection rate of 0.71/1,000 catheter days. Among the patients with hematological malignancies, those with acute leukemia were prone to CRBSI. Having previous bloodstream infection (BSI) (HR 18.139; 95% CI, 8.19-40.174; P < .0001), the number of PICCs insertions (HR 4.695; 95% CI, 1.842-11.967; P = .001) (twice), (HR 6.794; 95% CI, 1.909-24.181; P = .003) (≥3 times) were significantly associated with CRBSI. Not accompanied by chronic comorbidities (HR 0.34; 95% CI, 0.131-0.887; P = .028) and longer duration of PICC use (days) (HR 0.997; 95% CI, 0.994-0.999; P = .008) might be protective factors preventing CRBSI.
Our finding suggests that previous BSI and a higher number of PICC insertions are associated with an increased risk of CRBSI. A lack of chronic comorbidities may help prevent CRBSI.
本研究旨在探讨血液病患者血流感染并发症的发生情况和特征,并确定中心静脉导管相关性血流感染(CRBSI)的危险因素。
回顾性分析了 7 年间 291 例血液病患者共 391 例次经外周静脉穿刺中心静脉置管(PICC)置管术,对可能与 CRBSI 相关的因素进行了单因素和多因素 Cox 比例风险回归分析。采用风险比(HR)及其 95%置信区间(CI)来评估各预测因素与相关结局之间的关联。
291 例患者共置管 391 次,总计置管 63714 天,感染率为 0.71/1000 导管日。其中,急性白血病患者易发生 CRBSI。既往有血流感染(BSI)史(HR 18.139;95%CI,8.19-40.174;P <.0001)、PICC 置管次数(HR 4.695;95%CI,1.842-11.967;P =.001)(两次)和(HR 6.794;95%CI,1.909-24.181;P =.003)(≥3 次)与 CRBSI 显著相关。无慢性合并症(HR 0.34;95%CI,0.131-0.887;P =.028)和较长的 PICC 使用时间(天)(HR 0.997;95%CI,0.994-0.999;P =.008)可能是预防 CRBSI 的保护因素。
本研究结果表明,既往 BSI 和更多次的 PICC 置管与 CRBSI 风险增加相关,无慢性合并症可能有助于预防 CRBSI。