PVC placed in the antecubital area (OR 11.9, 95% CI (1.5, 95.7); P=0.02).
PVC duration > four days (OR 4.0, 95% CI (1.1, 15.2); P=0.04).
All cases successfully completed parenteral antibiotics with mean treatment length of 23.6 days.
There are several limitations to our study.
Given the retrospective nature, we were unable to investigate frequency of PVC access and ongoing PVC necessity nor observe adherence to insertion and maintenance protocols. A single point prevalence survey was used to estimate the total number of PVC days during the study period. The mean of several point prevalence surveys would increase the reliability of these estimates. This study was a single center experience resulting in a small sample size. Despite these limitations, our results are consistent with previous studies that show placement of PVCs in the antecubital area and prolonged PVC duration are associated with HO SAB.
Peripheral venous catheters (PVCs) are common in hospitals, but literature surrounding PVC-associated bacteremia is lacking. We describe incidence, risk factors, and outcomes related to PVC-associated Staphylococcus aureus bacteremia (SAB), a common cause of hospital-onset (HO) SAB.
his was a retrospective case-control study conducted at a 537-bed teaching community hospital during 2015-2016. Cases were adult inpatients with HO SAB with infectious diseases documentation of the PVC as the only source of bacteremia. Cases were matched 1:2 with controls on approximate PVC insertion date, age, mortality prediction score, and insurance type. Odds ratios (ORs) were estimated using conditional logistic regression. PVC utilization was estimated by a point prevalence survey from July 2017.
Of 205 SAB episodes, 160 were community-onset and 45 were HO; 16 (36%) HO cases were PVC-associated. Cases (n=16) were more likely than controls (n=32) to have a PVC placed in the antecubital area (OR 11.9, 95% CI (1.5, 95.7); P=0.02) and PVC duration > four days (OR 4.0, 95% CI (1.1, 15.2); P=0.04). The point prevalence of at least one PVC in adult inpatients was 86% and the incidence density of HO PVC-associated SAB was 0.15 per 1,000 PVC-days. Mean length of stay for cases was 13.2 days. All cases successfully completed parenteral antibiotics with mean treatment length of 23.6 days.
VC-associated SAB is a common cause of HO SAB resulting in significant morbidity. PVC placement in the antecubital area and line duration should be minimized to reduce HO SAB.