Lower risk of peripheral venous catheter-related bloodstream infection by hand insertion

Niccolò Buetti, Mohamed Abbas, Didier Pittet, Marie-Noëlle Chraiti, Valérie Sauvan, Marlieke E A De Kraker, Matthieu Boisson, Daniel Teixeira, Walter Zingg, Stephan Harbarth, Niccolò Buetti, Mohamed Abbas, Didier Pittet, Marie-Noëlle Chraiti, Valérie Sauvan, Marlieke E A De Kraker, Matthieu Boisson, Daniel Teixeira, Walter Zingg, Stephan Harbarth

Abstract

Introduction: Little is known about the bloodstream infection (BSI) risk associated with short-term peripheral venous catheters (PVCs) and no large study investigated the insertion site-related risk for PVC-BSI.

Methods: We performed a cohort study at the University of Geneva Hospitals using the prospective hospital-wide BSI surveillance database. We analyzed the association between insertion site and risk of PVC-BSI on the upper extremity using univariable and multivariable marginal Cox models.

Results: Between 2016 and 2020, utilization of 403'206 peripheral venous catheters were prospectively recorded in a 2000-bed hospital consortium with ten sites. Twenty-seven percent of PVC (n = 109'686) were inserted in the hand. After adjustment for confounding factors, hand insertion was associated with a decreased PVC-BSI risk (adjusted hazard ratio [HR] 0.42, 95% CI 0.18-0.98, p = 0.046) compared to more proximal insertion sites. In a sensitivity analysis for PVCs with ≥ 3 days of dwell time, we confirmed a decreased PVC-BSI risk after hand insertion (HR 0.37, 95% CI 0.15-0.93, p = 0.035).

Conclusion: Hand insertion should be considered for reducing PVC infections, especially for catheters with an expected dwell time of more than 2 days.

Keywords: Bloodstream infections; Catheter; Catheter-infection; Insertion site; Peripheral venous catheters.

Conflict of interest statement

The authors declare that they have no competing interests.

© 2022. The Author(s).

Figures

Fig. 1
Fig. 1
Flow-chart. PVC, Peripheral venous catheter
Fig. 2
Fig. 2
Unadjusted and adjusted PVC-BSI hazard ratio for hand insertion versus other upper extremity sites stratified by catheter duration. HR, hazard risk; CI, confidence interval; PVC, peripheral venous catheter. Adjustment variables: Sex, age and time admission—PVC insertion

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