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      The incidence and risk factors of peripherally inserted central catheter-related infection among cancer patients.

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          Abstract

          As the use of peripherally inserted central catheters (PICCs) increased in chemotherapy, the identification of complications and risk factors became essential to prevent patient harm. But little is known about PICC-related infection and risk factors among patients with cancer. Our study was to identify the prevalence, patterns, and risk factors of catheter-related infections associated with PICCs.

          Most cited references20

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          Guidelines for the prevention of intravascular catheter-related infections.

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            The risk of bloodstream infection associated with peripherally inserted central catheters compared with central venous catheters in adults: a systematic review and meta-analysis.

            Peripherally inserted central catheters (PICCs) are associated with central line-associated bloodstream infection (CLABSI). The magnitude of this risk relative to central venous catheters (CVCs) is unknown. To compare risk of CLABSI between PICCs and CVCs. MEDLINE, CinAHL, Scopus, EmBASE, and Cochrane CENTRAL were searched. Full-text studies comparing the risk of CLABSI between PICCs and CVCs were included. Studies involving adults 18 years of age or older who underwent insertion of a PICC or a CVC and reported CLABSI were included in our analysis. Studies were evaluated using the Downs and Black scale for risk of bias. Random effects meta-analyses were used to generate summary estimates of CLABSI risk in patients with PICCs versus CVCs. Of 1,185 studies identified, 23 studies involving 57,250 patients met eligibility criteria. Twenty of 23 eligible studies reported the total number of CLABSI episodes in patients with PICCs and CVCs. Pooled meta-analyses of these studies revealed that PICCs were associated with a lower risk of CLABSI than were CVCs (relative risk [RR], 0.62; 95% confidence interval [CI], 0.40-0.94). Statistical heterogeneity prompted subgroup analysis, which demonstrated that CLABSI reduction was greatest in outpatients (RR [95% CI], 0.22 [0.18-0.27]) compared with hospitalized patients who received PICCs (RR [95% CI], 0.73 [0.54-0.98]). Thirteen of the included 23 studies reported CLABSI per catheter-day. Within these studies, PICC-related CLABSI occurred as frequently as CLABSI from CVCs (incidence rate ratio [95% CI], 0.91 [0.46-1.79]). Only 1 randomized trial met inclusion criteria. CLABSI definition and infection prevention strategies were variably reported. Few studies reported infections by catheter-days. Although PICCs are associated with a lower risk of CLABSI than CVCs in outpatients, hospitalized patients may be just as likely to experience CLABSI with PICCs as with CVCs. Consideration of risks and benefits before PICC use in inpatient settings is warranted.
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              PICC-associated bloodstream infections: prevalence, patterns, and predictors.

              Growing use of peripherally inserted central catheters (PICCs) has led to recognition of the risk of PICC-associated bloodstream infection. We sought to identify rates, patterns, and patient, provider, and device characteristics associated with this adverse outcome.
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                Author and article information

                Journal
                Ther Clin Risk Manag
                Therapeutics and clinical risk management
                Informa UK Limited
                1176-6336
                1176-6336
                2015
                : 11
                Affiliations
                [1 ] President's Office, Qingdao, People's Republic of China.
                [2 ] Oncology Department, the Affiliated Hospital of Qingdao University, Qingdao, People's Republic of China.
                [3 ] Intensive Care Unit, Shanghai East Hospital, Shanghai, People's Republic of China.
                [4 ] Nursing Department, the Affiliated Hospital of Qingdao University, Qingdao, People's Republic of China.
                Article
                tcrm-11-863
                10.2147/TCRM.S83776
                4447175
                26045668
                6e8067ff-0686-4cf8-9062-265c818d6577
                History

                PICC,catheter-related bloodstream infection,clinical study,complication

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