Peripheral Line-associated Blood Stream Infection

Abstract

  Clinical manifestations, laboratory results, treatment methods, recurrence rates, and complications were studied in 38 patients who were diagnosed with peripheral line-associated blood stream infection (PLABSI) from June 1, 2010 to January 31, 2014 in our hospital. The median length of hospitalization was 17 days (range: 3–86 days), and the median time from catheter insertion to bacteremia was 5 days (2–15 days). The duration of antibiotic therapy after the diagnosis of PLABSI ranged from 7 to 100 days. Patients with complications such as osteomyelitis received longer durations of antibiotic therapy. The causative pathogen was Staphylococcus aureus in 6 cases (15.8%), coagulase-negative Staphylococcus in 12 cases (31.6%), Bacillus spp. in 4 cases (10.5%), Gram-negative rods in 20 cases (52.6%), and Candida spp. in 5 cases (13.2%). Polymicrobial bacteremia was observed in 10 cases. Seven patients had positive catheter cultures, whereas the catheter had already been removed in the other patients. Complications included suppurative thrombophlebitis, bacterial cellulitis, and osteomyelitis, which were diagnosed in 8 (21.1%), 3 (7.9%), and 2 (5.3%) patients, respectively. Four patients died within 30 days after diagnosis of PLABSI. Our results indicate the possible underdiagnosis of PLABSI, and demonstrate the potential for severe complications that may occur. PLABSI is a major health care-associated infection, but is not the target of major surveillance or research in Japan. Health care providers should carefully observe catheter insertion sites to prevent and correctly diagnose PLABSI.