Identifier to cite or link to this item: http://hdl.handle.net/20.500.13003/15875
Incidence of peripheral intravenous catheter failure among inpatients: variability between microbiological data and clinical signs and symptoms
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ISSN: 2047-2994
WOS ID: 000476710600003
Scopus EID: 2-s2.0-85069782323
PMID: 31367345
Embase PUI: L628653155
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2019-07-22Document type
research articleCitation
Blanco-Mavillard I, Rodriguez-Calero MA, De Pedro Gomez JE, Parra-Garcia G, Fernandez-Fernandez I, Castro-Sanchez E. Incidence of peripheral intravenous catheter failure among inpatients: variability between microbiological data and clinical signs and symptoms. Antimicrob Resist Infect Control. 2019 Jul 22;8:124.Abstract
BackgroundPeripheral intravenous catheters (PIVCs) are the most widely used invasive devices among inpatients. Catheter-related bloodstream infections (CRBSI) are serious yet preventable events for patients. Although the contribution of PIVCs towards these infections is gradually being recognised, its role in the Spanish setting is yet to be determined. We aimed to estimate the rate and incidence of PIVC failure at Manacor hospital (Spain) as baseline within a wider quality improvement initiative.MethodsTips from all PIVC removed during December 2017 and January 2018 in hospital wards were cultured semiquantitatively. The study population included all PIVCs inserted in adult patients admitted to any of three medical and one surgical wards, emergency department, critical care unit and operating rooms. Clinical, microbiological and ward information was collected by clinical researchers for each PIVC from insertion to removal on the study sites. CRBSI was defined per international guidelines (i.e., Centers for Disease Control and Prevention, USA). Data was analysed descriptively.ResultsSeven hundred and eleven tips were cultured, with 41.8% (297/711) reported as PIVC failure. The PIVC failure rate density-adjusted incidence for hospital length of stay (HLOS) was 226.2 PIVC failure/1000 HLOS. 5.8% (41/711) tips yielded positive isolates, with most frequent microorganisms Staphylococcus spp (S. epidermidis 29/41, 70.7%, S. aureus 2/41, 4.9%, S. hominis 2/41, 4.9%), and Acinetobacter baumannii (1/41, 2.4%). One S. aureus isolate was methicillin-resistant. 53.6% (22/41) positive cultures were obtained from patients with local signs and symptoms compatible with catheter-related infection (CRI), 2.4% (1/41) were compatible with CRBSI type 2 and that clinical signs improve within 48h of catheter removal (density-adjusted incidence for hospital stays of 16.7 PIVC-CRI/1000 hospital-stays and 0.76 PVC-BSI/1000 hospital-stays respectively) and no patients were diagnosed CRBSI type 3 with a bacterial growth concordant in tip and blood cultures. Most cases responded favourably to catheter removal and management.ConclusionsOur findings show that almost 42% PIVCs resulted in unplanned removal, amplifying the importance in terms of morbidity, mortality and patient safety. A high number of positive tip cultures without clinical signs and symptoms was observed. We underpin the importance to remove unnecessary PIVCs for the prevention of CRBSI.
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https://dx.doi.org/10.1186/s13756-019-0581-8Keywords
Peripheral intravenous catheterCatheter failure
Adverse events
Catheter-related bloodstream infections
Vascular access device
MeSH
BacteremiaCatheterization, Peripheral
Aged, 80 and over
Aged
Bacteria
Spain
Length of Stay
Device Removal
Humans
Middle Aged
Bacteriological Techniques
Patient Safety
Intensive Care Units
Male
Prospective Studies
Female
Phylogeny
Catheter-Related Infections
DeCS
Remoción de DispositivosSeguridad del Paciente
Femenino
Unidades de Cuidados Intensivos
Masculino
Filogenia
Tiempo de Internación
Técnicas Bacteriológicas
Humanos
Persona de Mediana Edad
Estudios Prospectivos
Anciano
Anciano de 80 o más Años
Bacteriemia
Cateterismo Periférico
Infecciones Relacionadas con Catéteres
España
Bacterias
This item appears in following Docusalut collections
Hospital de Manacor - HMAN > Comunicación científicaInstituto de Investigación Sanitaria Islas Baleares - IDISBA > Comunicación científica