More than one in 10 catheter-related bloodstream infections due to Staph aureus in hospitalized adults are caused by infected peripheral venous catheters (PVC), says a new study from Rhode Island Hospital.
The study points out the substantial medical burden that arises from complications from these infections due to the large number of such catheters used in hospitalized patients. The study is published in the journal Infection Control and Hospital Epidemiology and is now available online in advance of print.
Senior author Leonard Mermel, D.O., Sc.M., medical director of epidemiology and infection control at Rhode Island Hospital, and his colleagues note that Staphylococcus aureus is the second most common cause of hospital-acquired bloodstream infections. It is the pathogen most often associated with serious and costly catheter-related bloodstream infection. Thus, they were interested in investigating Staph aureus bloodstream infections associated with the commonly used PVCs.
Mermel says, "While a published meta-analysis suggests that changing PVCs every three days does not reduce infection risk, in one national survey, more than 90 percent of PVC sepsis cases were due to PVCs in place for three or more days. Another published study found an independent, linear relationship between PVC infectious complications and the length of time the PVC was in place."
Mermel notes, "Peripheral venous catheter infections have been deemphasized as most of our national and local preventative efforts have focused on central venous catheters. In our study, we documented 24 PVC-related Staph aureus bloodstream infections among 77,852 hospital discharges. Based on these figures, we estimate there are approximately 10,000 PVC-related Staph aureus bloodstream infections each year in adults hospitalized in the United States."
T. Tony Trinh, MD, the lead author of the study, says, "Peripheral venous catheters, also known as peripheral IVs, are a ubiquitous aspect of hospital patient care. Our study sheds an important light on the underappreciated and significant risks of peripheral IVs."
Based on this study, Mermel concludes, "Our study suggests that hospitals should assess their risk of PVC-related infections and initiate interventions to mitigate risk if such infections are found. Further, minimizing PVC placement in the antecubital fossa, consideration for removing catheters within 24 hours if they were placed under emergency conditions, and strong consideration for replacing PVCs after a 72-hour dwell time will reduce the risk of infection in adult patients."