671. Prospective Evaluation of Peripherally Inserted Central Catheters in Both Inpatient and Outpatient Settings
Session: Poster Abstract Session: Preventing Catheter Associated Infections
Friday, October 21, 2011
Room: Poster Hall B1

Background:  Long-term intravenous access is needed for medication administration including antibiotics, total parental nutrition, and chemotherapy.  The trend in long-term IV access has been shifting more towards peripherally inserted central catheters (PICC) in contrast to surgically placed catheters.  There are limited comprehensive prospective studies assessing the rates and severity of these complications.   A prospective cohort study was performed to further clarify complications.

Methods:  Patients at the Ohio State University Medical Center were prospectively enrolled during routine PICC placement by PICC Team nurses at the time of insertion.  A medical record abstraction was performed, followed by bimonthly phone calls assessing PICC status including home care, PICC line issues, and catheter duration. Patients were followed until PICC line removal.

Results:  To date, 162 patients have been enrolled with removal in 114 patients.  These 114 patients encompass 3,143 catheter days.  Among these, 19 patients experienced complications: 5 (4.3%) patients with PICC line infections (rate is 1.59 infections/1000 catheter days), 6 (5.2%) patients with thrombosis (rate=1.9), 4 patients with catheter fracture or malpostion, and 2 patients for which the PICC line “fell out”.   Of the 5 patients with PICC related bacteremias, 3 were discharged and subsequently readmitted with infection.  PICC line infections were established at 30, 71, and 77 days in these three outpatients, with cultures demonstrating Stenotrophomonas maltophilia, Staphylococcus hominis, and methicillin resistant Staphylococcus epidermidis respectively.  Among the 2 patients with inpatient PICC line related bacteremia, one occurred in a patient on TPN (E.. fecalis, Proteus mirabilis) and one in an injection drug user  (Acinetobacter baumanni, Pseudomonas aeruginosa). 

Conclusion:  In this prospective cohort, complication rates in PICC lines were low; thus they appear to be safe for extended time intervals in the outpatient setting.  Rigorous home health follow-up with PICC line care is essential along with immediate removal of the PICC line once therapy has been discontinued.


Subject Category: N. Hospital-acquired and surgical infections, infection control, and health outcomes including general public health and health services research

Christina Liscynesky, MD, James Joseph, RN, BSN, Patricia Keller, RN, BSN, Debra Wells, RN, BSN, Patricia Sanders, RN, BSN and Kurt Stevenson, MD, MPH, The Ohio State University Medical Center, Columbus, OH

Disclosures:

C. Liscynesky, None

J. Joseph, None

P. Keller, None

D. Wells, None

P. Sanders, None

K. Stevenson, None

Findings in the abstracts are embargoed until 12:01 a.m. EST Thursday, Oct. 20 with the exception of research findings presented at IDSA press conferences.