scholarly journals Risk factors and clinical analysis of peripherally inserted central catheter-related fungal colonization in premature infants

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Lingping Zhang ◽  
Liu Yang ◽  
Wenbin Dong ◽  
Xingling Liu ◽  
Xiaoping Lei ◽  
...  
Keyword(s):  
Risk Factors ◽  
Parenteral Nutrition ◽  
Premature Infants ◽  
Roc Curves ◽  
Antibiotic Use ◽  
Clinical Analysis ◽  
Fungal Colonization ◽  
Peripherally Inserted Central Catheter ◽  
Central Catheter ◽  
Treatment Information

AbstractWe aimed to analyze the risk factors of positive peripherally inserted central catheter (PICC)-related fungal colonization in preterm infants. This retrospective study collected data from 2018 to 2020. The enrolled infants who underwent PICC insertion were born at < 32 weeks’ gestation or birth weight < 1500 g. The demographics, PICC-related characteristics, and treatment information were collected. Univariate and multivariate analyses were performed to investigate risk factors for PICC-related fungal colonization. The receiver operating characteristic (ROC) curve was used to determine the optimal cut-off values for the duration of antibiotics and parenteral nutrition. In total, 124 premature infants underwent PICC insertion. Among them, 19 patients had positive results of fungi on the PICC tips. The duration of antibiotics (odds ratio [OR] 1.16, 95% confidence interval [CI] 1.02–1.31), parenteral nutrition infusion (OR 1.27, 95% CI 1.05–1.54), and postnatal glucocorticoid exposure (OR 9.48, 95% CI 1.06–84.98) were independent risk factors for fungal colonization in PICCs. The ROC curves showed that the risk increased after 15 days of antibiotic use and 28 days of parenteral nutrition infusion. Appropriate clinical management should be used to prevent fungal colonization and fungemia.

Risk Factors and Clinical Analysis for PICC Related Fungal Colonization in Premature Infants

2021 ◽  
Author(s):  
Lingping Zhang ◽  
Liu Yang ◽  
Wenbin Dong ◽  
Xingling Liu ◽  
Xiaoping Lei ◽  
...  
Keyword(s):  
Risk Factors ◽  
Premature Infants ◽  
Operating Characteristic ◽  
Tertiary Hospital ◽  
Clinical Analysis ◽  
Fungal Colonization ◽  
Ultrasound Guided ◽  
Independent Risk Factors ◽  
Positive Results ◽  
Infusion Duration

Abstract Objective: The present study aimed to analyze the risk factors for positive peripherally inserted central catheter (PICC) related fungal colonization in preterm infants. Methods: A retrospective study was conducted in a tertiary hospital in southwest China between January 1, 2018 and December 31, 2020. The enrolled infants who underwent ultrasound-guided PICC insertion during hospitalization were born at < 32 weeks gestation or birth weight < 1500 grams. The demographics, the PICC related characteristics, the use of antibiotic, glucocorticoid and parenteral nutrition (PN) were collected from the medical record. Univariate and multivariate analyses were performed to investigate risk factors for PICC-related fungal colonization. Receiver operating characteristic (ROC) curve was used to determine the optimal cut-off value by calculating the Yoden index. Results: A total of 124 premature infants underwent ultrasound-guided PICC insertion. Among them, 19 patients had positive results of fungi at PICC tips.PN infusion duration (OR 1.37, 95%CI 1.05-1.79) and postnatal glucocorticoid exposure(OR 9.19, 95%CI 1.04-81.65) were independent risk factors for fungal colonization in PICC. The optimal cut-off value was 15days,28days, respectively. Conclusion: PICC tips fungal colonization is affected by postnatal glucocorticoid exposure and PN infusion duration. Appropriate clinical management should be adopted to avoid fungal colonization and fungemia.

Screening for novel risk factors related to peripherally inserted central catheter-associated complications

2014 ◽  
Vol 9 (8) ◽  
pp. 481-489 ◽  
Author(s):  
Jennifer Moran ◽  
Colleen Y. Colbert ◽  
Juhee Song ◽  
Jane Mathews ◽  
Alejandro C. Arroliga ◽  
...  
Keyword(s):  
Risk Factors ◽  
Peripherally Inserted Central Catheter ◽  
Central Catheter ◽  
Novel Risk Factors

scholarly journals The development of a risk score for unplanned removal of peripherally inserted central catheter in newborns

2015 ◽  
Vol 23 (3) ◽  
pp. 475-482 ◽  
Author(s):  
Priscila Costa ◽  
Amélia Fumiko Kimura ◽  
Debra Huffman Brandon ◽  
Eny Dorea Paiva ◽  
Patricia Ponce de Camargo
Keyword(s):  
Risk Factors ◽  
Risk Score ◽  
Neonatal Intensive Care ◽  
Operating Characteristic ◽  
Bivariate Analysis ◽  
Peripherally Inserted Central Catheter ◽  
Central Catheter ◽  
Single Lumen ◽  
Double Lumen Catheter ◽  
Lumen Catheter

OBJECTIVE: to develop a risk score for unplanned removal of peripherally inserted central catheter in newborns.METHOD: prospective cohort study conducted in a neonatal intensive care unit with newborn babies who underwent 524 catheter insertions. The clinical characteristics of the newborn, catheter insertion and intravenous therapy were tested as risk factors for the unplanned removal of catheters using bivariate analysis. The risk score was developed using logistic regression. Accuracy was internally validated based on the area under the Receiver Operating Characteristic curve.RESULTS: the risk score was made up of the following risk factors: transient metabolic disorders; previous insertion of catheter; use of a polyurethane double-lumen catheter; infusion of multiple intravenous solutions through a single-lumen catheter; and tip in a noncentral position. Newborns were classified into three categories of risk of unplanned removal: low (0 to 3 points), moderate (4 to 8 points), and high (≥ 9 points). Accuracy was 0.76.CONCLUSION: the adoption of evidence-based preventative strategies based on the classification and risk factors faced by the newborn is recommended to minimize the occurrence of unplanned removals.

Peripherally inserted central catheter-related complications in cancer patients: a prospective study of over 50,000 catheter days

2017 ◽  
Vol 18 (2) ◽  
pp. 153-157 ◽  
Author(s):  
Junren Kang ◽  
Wei Chen ◽  
Wenyan Sun ◽  
Ruibin Ge ◽  
Hailong Li ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cancer Patients ◽  
Multivariable Analysis ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Multivariable Logistic Regression Analysis ◽  
Peripherally Inserted Central Catheter ◽  
Central Catheter ◽  
Multicenter Cohort Study ◽  
Related Factors

Purpose To evaluate incidence and risk factors of peripherally inserted central catheter (PICC)-related complications in cancer patients. Methods A prospective, multicenter, cohort study of cancer patients with PICC insertion was performed from February 1, 2013 to April 24, 2014. All patients were monitored in clinic until PICCs were removed. The primary endpoint was PICC removal due to complications. Patient-, catheter- and insertion-related factors were analyzed in univariable and multivariable logistic regression analysis to identify significant independent risk factors for PICC-related complications. Results There were 477 cancer patients included, for a total of 50,841 catheter-days. Eighty-one patients (17.0%) developed PICC-related complications, with an incidence of 1.59 per 1000 catheter days. Thirty-six (7.5%) PICCs were removed because of complications. The most common complications were skin allergy (4.6%), catheter occlusion (3.4%) and accidental withdrawal (2.3%). Nine (1.9%) patients developed symptomatic upper extremity deep venous thrombosis (UEDVT) and central line associated bloodstream infection (CLABSI) was shown in six (1.3%) PICCs with an infection rate 0.12 per 1000 catheter days. In multivariable analysis, body mass index (BMI) >25 (odds ratio, 2.09; 95% confidence interval, 1.26-3.47, p = 0.004) was shown to be a significant risk factor for PICC complications. Conclusions Cancer patients with BMI greater than 25 were more likely to have PICC complications.

The Role of a Single Dose of Vancomycin in Reducing Clinical Sepsis in Premature Infants Prior to Removal of Peripherally Inserted Central Catheter: A Retrospective Study

2018 ◽  
Vol 35 (10) ◽  
pp. 990-993
Author(s):  
Lovya George ◽  
Michael Malloy ◽  
Rafael Fonseca ◽  
Vidit Bhargava
Keyword(s):  
Single Dose ◽  
Premature Infants ◽  
Exposed Group ◽  
P Value ◽  
Peripherally Inserted Central Catheter ◽  
Central Catheter ◽  
Clinical Sepsis ◽  
Picc Line ◽  
Culture Positive

Objective Peripherally inserted central catheter (PICC) line removal is associated with bloodstream infections and clinical sepsis. We aim to investigate the role of a single prophylactic dose of vancomycin in decreasing the incidence of central line associated bloodstream infection associated with PICC removal. Methods A retrospective chart review of patients in the neonatal intensive care unit was conducted. Patients were divided into two study groups based on whether a single dose of vancomycin was administered (exposed) or not (nonexposed). The primary outcome measured was clinical sepsis with or without positive blood culture. Results The incidence of clinical sepsis in the exposed group was 7.3% compared with 6.3% in the nonexposed group (p-value: 0.7860). The incidence of culture-positive sepsis in the exposed group was 2.2% compared with 1.6% in the nonexposed group (p-value: 0.7673). The overall incidence of clinical and culture-positive sepsis in the subgroup with infants weighing <1,500 g and <32 weeks' gestational age was similar to the main study group. Conclusion Our data do not support routine vancomycin prophylaxis prior to PICC line removal in premature infants to prevent sepsis associated with PICC removal. However, a large randomized controlled trial is further needed to delineate these results.

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