1. Risk of Infection Using Peripherally Inserted Central and Umbilical Catheters in Preterm Neonates.
- Author
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Shalabi, Mohamed, Adel, Mohamed, Yoon, Eugene, Aziz, Khalid, Shoo Lee, and Shah, Prakesh S.
- Subjects
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CATHETER-related infections , *CATHETERIZATION , *CHI-squared test , *MULTIVARIATE analysis , *POISSON distribution , *T-test (Statistics) , *UMBILICAL cord , *RETROSPECTIVE studies , *PERIPHERALLY inserted central catheters , *MANN Whitney U Test , *CHILDREN , *DISEASE risk factors - Abstract
OBJECTIVE: To compare the rates of catheter-associated bloodstream infection (CABSI) in preterm infants born at <30 weeks' gestation who received a peripherally inserted central catheter (PICC) versus an umbilical venous catheter (UVC) immediately after birth as their primary venous access. METHODS: This retrospective matched cohort study examined data from infants born at <30 weeks' gestation and admitted between January 2010 and December 2013 to neonatal units in the Canadian Neonatal Network. Eligible infants who received a PICC on the first day after birth (day 1) were matched with 2 additional groups of infants, those who received a UVC on day 1 and those who received a UVC on day 1 that was then changed for a PICC after 4 days or more. The primary outcome was number of infants with CABSI per 1000 catheter days, which was compared between the 3 groups using multivariable analyses. RESULTS: Data from 540 eligible infants were reviewed (180 per group). There was no significant difference in infants with CABSI/1000 catheter days between the 3 groups (9.3 vs 7.8 vs 8.2/1000 catheter days, respectively; P > .05) despite lower rates of late onset sepsis in the group of infants who received only a UVC. CONCLUSIONS: There was no significant difference in the incidence of CABSI between very preterm neonates who received a PICC, UVC, or UVC followed by PICC as the primary mode of venous access after birth. A prospective randomized controlled trial is justified to further guide practice regarding primary venous access and reduction of infection. [ABSTRACT FROM AUTHOR]
- Published
- 2015
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