OBJECTIVE: To evaluate the effects of peripheral introvascular central catheters (PICC) on the catheter-associated bloodstream infections (CRBSI) and the formations of catheter-related bloodstream infections. METHODS: Total of 483 patients with hematologic malignancies admitted in our hospital from January 2013 to December 2016 were enrolled in this study, and 612 PICC catheterization were conducted. The median time of catheterization was 101 d (48 ∼ 184 d) . The incidence rates of CRBSI and CRTC were observed, and the CRBSI and CRTC associated variables were also analyzed. RESULTS: There were 47 cases of CRBSI (7.7%), and the incidence was 0.59‰ PICC days, and there were 16 cases of CRTC (2.6%), with the incidence of 0.20‰ PICC days. Meanwhile, no other related serious complications found. The Cox regression analysis of CRBSI and CRTC-associated variables showed that the acute leukemia was significantly related with a higher incidence of CRBSI as compared with the other type of disease, however, which was not significantly related with the CRTC. CONCLUSION Compared with the traditional CVAD catheterization, the PICC is more safe and effective for the patients with malignant tumors, thus which may become a alternative method for CVAD.
Catheter-Related Infections ; etiology ; Catheterization, Central Venous ; adverse effects ; Hematologic Diseases ; Humans ; Incidence ; Risk Factors ; Thrombosis ; etiology

Adult ; Catheter-Related Infections ; etiology ; Catheterization, Central Venous ; instrumentation ; Central Venous Catheters ; adverse effects ; Female ; Humans ; Pulmonary Embolism ; etiology ; Recurrence ; Sepsis ; etiology ; Tomography, X-Ray Computed

This study investigated the safety and effectiveness of each type of central venous catheters (CVC) in patients with cancer. We prospectively enrolled patients with cancer who underwent catherization involving a subclavian venous catheter (SVC), peripherally inserted central venous catheter (PICC), or chemo-port (CP) in our department. From March 2007 to March 2009, 116 patients underwent 179 episodes of catherization. A SVC was inserted most frequently (46.4%). Fifty-four complications occurred (30.1%): infection in 23 cases, malpositioning or migration of the tip in 18 cases, thrombosis in eight cases, and bleeding in five cases. Malpositioning or migration of the tip occurred more frequently with a PICC (P<0.001); infection occurred more often with a tunneled catheter (P=0.028) and was observed more often in young patients (P=0.023). The catheter life span was longer for patients with solid cancer (P=0.002) than for those with hematologic cancer, with a CP (P<0.001) than a PICC or SVC, and for an indwelling catheter with image guidance (P=0.014) than a blind procedure. In conclusion, CP is an effective tool for long term use and the fixation of tip is important for the management of PICC.
Adult ; Aged ; Aged, 80 and over ; Catheter-Related Infections/epidemiology/etiology ; Catheterization, Central Venous/*adverse effects ; Catheterization, Peripheral/adverse effects ; Equipment Failure ; Female ; Hemorrhage/epidemiology/etiology ; Humans ; Male ; Middle Aged ; Neoplasms/*drug therapy ; Prospective Studies ; Risk Factors ; Thrombosis/epidemiology/etiology

OBJECTIVES: To study the features of catheter-related bloodstream infection (CRBSI) or central line-associated bloodstream infection (CLABSI) after peripherally inserted central catheterization (PICC) in neonates admitted to the neonatal intensive care unit (NICU) and the risk factors for CRBSI or CLABSI. METHODS: A retrospective analysis was performed on the medical data of the neonates who were treated and required PICC in the NICU of the Children's Hospital, Zhejiang University School of Medicine from June 1, 2018 to May 1, 2020. The catheterization-related data were collected, including placement time, insertion site, removal time, and antimicrobial lock of PICC. The multivariate logistic regression model was used to investigate the risk factors for CRBSI or CLABSI in the neonates. RESULTS: A total of 446 neonates were enrolled, with a mean gestational age of (30.8±4.0) weeks, a mean birth weight of (1 580±810) g, a median age of 9 days, and a median duration of PICC of 18 days. The incidence rates of CLABSI and CRBSI were 5.6 and 1.46 per 1 000 catheter days, respectively. Common pathogens for CLABSI caused by PICC included Staphylococcus epidermidis (n=19) and Klebsiella pneumoniae (n=11), and those for CRBSI caused by PICC included Klebsiella pneumoniae (n=6). The risk of CLABSI caused by PICC increased significantly with prolonged durations of PICC and antibiotic use, and the PICC-related infection probability at head and neck was significantly lower than that in the upper and low limbs (P<0.05), while the above conditions were more obvious in neonates with a birth weight of <1 500 g. The risk of CRBSI caused by PICC decreased with the increase in gestational age (P<0.05). CONCLUSIONS CRBSI and CLABSI remain serious issues in NICU nosocomial infection. The identification of the risk factors for CRBSI and CLABSI provides a basis for improving the quality of clinical care and management.
Catheter-Related Infections/etiology* ; Catheterization, Central Venous/adverse effects* ; Catheterization, Peripheral/adverse effects* ; Central Venous Catheters/adverse effects* ; Child ; Humans ; Infant ; Infant, Newborn ; Retrospective Studies ; Risk Factors ; Sepsis/etiology*