Clinical Features of Catheter-related Bloodstream Infections and Persistent Infections Associated with Early Catheter Reinsertion: A 6-year Retrospective Study.

INTRODUCTION

Catheter-related persistent infections (CRPCI) may develop after catheter-related bloodstream infections (CRBSI) due to colonization of the newly inserted catheter. However, the optimal timing for new catheter insertion remains controversial. The aim of this study was to determine the clinical features of CRBSI due to species and CRPCI. This was a retrospective study conducted in a teaching hospital in Japan.

METHODS

We retrospectively collected clinical information on hospitalized patients diagnosed with CRBSIs by catheter tip culture from 2015 to 2020. CRPCI was defined as the growth of the same species from the tip culture of a newly inserted catheter after the onset of a CRBSI. The Chi-squared and Fisher's exact tests were used to compare differences between the case and control groups.

RESULTS

Sixty-three cases of CRBSI were collected. Fifty-four (85.7%) received total parenteral nutrition. CRPCI developed in 12 (48%) patients of the 25 in whom cultures of newly inserted catheters were performed. Despite antifungal therapy in these patients, persistent fungemia incidence was significantly higher (50.0% vs. 9.1%, odds ratio = 10.0, = 0.033). The mean number of days from removal of infected catheter to reinsertion was significantly shorter for patients with CRPCI (0.27 days vs. 3.08 days, = 0.038).

CONCLUSIONS

Total parenteral nutrition may be a major risk factor in the development of CRBSI. CRPCI often leads to persistent fungemia. Early insertion of a new catheter after removal of an infected catheter may be a risk factor for CRPCI.