Outcomes associated with early removal versus retention of peripherally inserted central catheters after diagnosis of catheter-associated infections in neonates. (16th December 2016)

• Record Type: Journal Article
• Authors: Deshpande, Poorva; Jain, Amish; Shah, Prakesh S.
• Is Part Of: Journal of maternal-fetal & neonatal medicine. Volume 29:Number 24(2016)
• Page Start: 4082
• Page End: 4087
• Publication Date: 2016-12-16
• Subjects: Central line-associated bloodstream infection -- neonatal nosocomial infections -- peripherally inserted central catheters; Obstetrics -- Periodicals; Perinatology -- Periodicals; Infants (Newborn) -- Diseases -- Periodicals; Neonatology -- Periodicals; 618.2
• DOI: 10.3109/14767058.2016.1157578
• Languages: English
• ISSNs: 1476-7058

Abstract

Abstract: Objective : To compare clinical outcomes and hospital resource utilization of infants who had peripherally inserted central catheters removed early versus retained following diagnosis of central line-associated bloodstream infection. Study Design : In a single centre retrospective cohort study, we compared outcomes of infants who had peripherally inserted central catheters removed early versus retained after diagnosis of central line-associated bloodstream infection. Mortality, cardio-respiratory deterioration, use of blood products and antibiotics were compared between groups. Results : Over a 10-year period, of the 119 eligible infants, 38 had peripherally inserted central catheters removed early and 81 had catheters retained after diagnosis of central line-associated bloodstream infection. Baseline demographics, illness severity at onset of sepsis and distribution of organisms were similar between the groups. Infants in "catheter–retained" group required longer antibiotic usage (17 ± 9 versus 13 ± 6 days; p = 0.025) and more frequent sequential positive blood cultures [31/81 (47%) versus 8/38 (22%), p = 0.014). Infants with Gram-negative bacteremia demonstrated higher mortality when catheters were retained [43% (9/21) versus 7% (1/14); p = 0.028]. Conclusions : Retaining peripherally inserted central catheters after diagnosis of central line-associated bloodstream infection was associated with longer duration of bacteremia and prolonged exposure to systemic antibiotics as well as increased mortality in Gram-negative bacteremia.