1. Outcomes associated with early removal versus retention of peripherally inserted central catheters after diagnosis of catheter-associated infections in neonates.
- Author
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Deshpande, Poorva, Jain, Amish, and Shah, Prakesh S
- Subjects
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ANTIBIOTICS , *CATHETERS , *COMPARATIVE studies , *GESTATIONAL age , *INTRAVENOUS catheterization , *RESEARCH methodology , *MEDICAL cooperation , *NONPARAMETRIC statistics , *RESEARCH , *TIME , *EVALUATION research , *RETROSPECTIVE studies , *SEVERITY of illness index , *MEDICAL device removal , *CENTRAL venous catheters , *ODDS ratio , *CATHETER-related infections , *DIAGNOSIS , *THERAPEUTICS - 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. [ABSTRACT FROM AUTHOR]- Published
- 2016
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