Infection Control Program and WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, Service PCI, Rue Gabrielle-Perret-Gentil 4, 1205, Geneva, Switzerland.
UMR 1137, IAME, INSERM, Université de Paris, 75018, Paris, France.
Antimicrob Resist Infect Control. 2022 Jun 3;11(1):80. doi: 10.1186/s13756-022-01117-8.
Little is known about the bloodstream infection (BSI) risk associated with short-term peripheral venous catheters (PVCs) and no large study investigated the insertion site-related risk for PVC-BSI.
We performed a cohort study at the University of Geneva Hospitals using the prospective hospital-wide BSI surveillance database. We analyzed the association between insertion site and risk of PVC-BSI on the upper extremity using univariable and multivariable marginal Cox models.
Between 2016 and 2020, utilization of 403'206 peripheral venous catheters were prospectively recorded in a 2000-bed hospital consortium with ten sites. Twenty-seven percent of PVC (n = 109'686) were inserted in the hand. After adjustment for confounding factors, hand insertion was associated with a decreased PVC-BSI risk (adjusted hazard ratio [HR] 0.42, 95% CI 0.18-0.98, p = 0.046) compared to more proximal insertion sites. In a sensitivity analysis for PVCs with ≥ 3 days of dwell time, we confirmed a decreased PVC-BSI risk after hand insertion (HR 0.37, 95% CI 0.15-0.93, p = 0.035).
Hand insertion should be considered for reducing PVC infections, especially for catheters with an expected dwell time of more than 2 days.
关于短期外周静脉导管（PVC）相关的血流感染（BSI）风险知之甚少，也没有大型研究调查过 PVC-BSI 的插入部位相关风险。
我们使用前瞻性的全院 BSI 监测数据库，在日内瓦大学医院进行了一项队列研究。我们使用单变量和多变量边缘 Cox 模型分析了上肢插入部位与 PVC-BSI 风险之间的关联。
在 2016 年至 2020 年间，2000 张床位的医院联盟前瞻性地记录了 403206 根外周静脉导管的使用情况，其中 10 个站点。27%的 PVC（n=109686）被插入手部。在调整混杂因素后，与更靠近近端的插入部位相比，手部插入与 PVC-BSI 风险降低相关（调整后的危险比 [HR] 0.42，95%置信区间 0.18-0.98，p=0.046）。在手插入 PVC 导管留置时间≥3 天的敏感性分析中，我们确认手部插入后 PVC-BSI 风险降低（HR 0.37，95%置信区间 0.15-0.93，p=0.035）。
应考虑手部插入以降低 PVC 感染的风险，特别是对于预计留置时间超过 2 天的导管。
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