Peripheral intravenous catheter‐associated Staphylococcus aureus bacteraemia: more than 5 years of prospective data from two tertiary health services. Issue 10 (3rd June 2013) - Stuart, Rhonda L
Abstract: Objectives: To determine the incidence, risk factors for and outcomes of Staphylococcus aureus bacteraemia (SAB) associated with peripheral intravenous catheters (PIVCs). Design, setting and patients: A review of prospectively collected data from two tertiary health services on all health care‐associated SAB episodes occurring in adults aged > 17 years from January 2007 to July 2012. Main outcome measures: Numbers of health care‐associated SAB episodes; device type, location of insertion, device dwell time and outcome at 7 and 30 days for all SAB episodes associated with use of a PIVC; rates of SAB per 10 000 occupied bed‐days (OBDs). Results: Overall, 137 of 583 health care‐associated‐SAB episodes (23.5%) were deemed to be PIVC associated, with an incidence of 0.26/10 000 OBD. The mean dwell time for PIVCs was 3.5 days (range, 0.25–9 days) and 45.2% of SABs occurred in PIVCs with a dwell time ≥ 4 days. Of the PIVC‐associated SAB episodes, 39.6% involved PIVCs inserted in the ED, 39.6% involved PIVCs inserted on wards and 20.8% involved PIVCs inserted by the ambulance service. Of the PIVC‐associated SABs occurring within 4 days of insertion, 61% were inserted by ED staff or the ambulance service. PIVC‐associated SAB were associated with a 30‐day all‐cause mortality rate of 26.5%. Conclusion: PIVC‐associated SAB is an under‐recognised complication. The high incidences of SAB associated with PIVCs inserted in emergency locations and with prolonged dwell times support recommendations in clinical guidelines for routine removal of PIVCs.