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Is an Increased Dwell Time of a Peripherally Inserted Catheter Associated With an Increased Risk of Bloodstream Infection in Infants?

Published online by Cambridge University Press:  02 January 2015

P. Brian Smith ,
Daniel K. Benjamin Jr. ,
C. Michael Cotten ,
Eric Schultz ,
Rose Guo ,
Lisa Nowell ,
Mary Laura Smithwick  and
Courtney D. Thornburg
P. Brian Smith*
Affiliation:
Department of Pediatrics, Duke University, Durham, North Carolina Duke Clinical Research Institute, Durham, North Carolina
Daniel K. Benjamin Jr.
Affiliation:
Department of Pediatrics, Duke University, Durham, North Carolina Duke Clinical Research Institute, Durham, North Carolina
C. Michael Cotten
Affiliation:
Department of Pediatrics, Duke University, Durham, North Carolina
Eric Schultz
Affiliation:
Department of Pediatrics, Duke University, Durham, North Carolina
Rose Guo
Affiliation:
Department of Pediatrics, Duke University, Durham, North Carolina
Lisa Nowell
Affiliation:
Department of Pediatrics, Duke University, Durham, North Carolina
Mary Laura Smithwick
Affiliation:
Department of Pediatrics, Duke University, Durham, North Carolina
Courtney D. Thornburg
Affiliation:
Department of Pediatrics, Duke University, Durham, North Carolina
*
Duke Clinical Research Institute, P.O. Box 17969, Durham, NC 27715 (brian.smith@duke.edu)
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Abstract

Objective.

To estimate the risk of bloodstream infection associated with catheter dwell time in infants.

Design.

Retrospective study.

Setting.

Duke University Medical Center neonatal intensive care unit, an academic, level 3 nursery in Durham, North Carolina.

Methods.

A case of catheter-associated bloodstream infection was defined as one that occurred in an infant whose culture-positive blood sample was collected more than 24 hours after catheter insertion or within 72 hours after catheter removal. We used multivariable logistic regression to control for the catheter's position and dwell time as well as the infant's sex, gestational age, age at time of catheter insertion, birth weight, and weight at time of catheter insertion.

Results.

We identified 135 cases of catheter-associated bloodstream infection. The mean catheter dwell time was 12.2 days (range, 0–113 days), and the mean time to bloodstream infection was 10.8 days (range, 1–57 days). An increase in catheter dwell time was associated with a lower risk of bloodstream infection (odds ratio, 0.975 [95% confidence interval, 0.954–0.996]; P = .02).

Conclusion. No

increased risk of catheter-associated bloodstream infection was observed with increased catheter dwell time. This may have been due to the infant's improved nutrition, decreased need for other invasive devices, and maturing skin and immune system as catheter dwell time increased.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 29 , Issue 8 , August 2008 , pp. 749 - 753
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2008

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