Methods: Memorial Sloan Kettering Cancer Center is a tertiary care center in NYC. Patients with PICC line placement for all indications between 11/1/2013 and 7/31/2014 were retrospectively identified from an institutional database. Positive blood cultures were obtained from microbiology surveillance reports and NHSN criteria were applied to establish if primary CLABSI event occurred. Patients were monitored for positive blood cultures between 11/1/2013 and 9/31/2014. Potential covariates were identified via chart review and included PICC placement setting (outpatient vs inpatient), service (if inpatient), age at time of procedure, current diabetes status, any history of radiation, any history of total parenteral nutrition (TPN), bicep circumference and catheter length measured in centimeters, and concurrent or a history of previous central lines. Fisher’s exact tests were used to determine statistically significant differences.
Results: During the study period, 920 PICCs were inserted in 766 patients. The overall incidence of PICC related infection was 2.71% (25/920). Hematologic malignancies, small arm circumference, and previous or concurrent catheter were significant predictors of infection. Gender, mean catheter length, and PICC placement in an outpatient setting were marginally associated with infection. Age, TPN, radiation, and diabetes status were not significant predictors of PICC infection.
Conclusion: Our PICC rates are lower than previously described from our and other centers. We attribute this to catheter maintenance practices implemented since 2013. Persons with hematologic malignances and those with previous or concomitant central lines had a significantly higher risk for primary CLABSI events and should be a target population for supplemented catheter care interventions.
N. Bell, None
J. Eagan, None
M. Kamboj, None