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Vol.34 No.6 contents | Japanese/English |
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Full Text of PDF (419K) Article in Japanese |
Risk Factors for Peripherally-Inserted Central Catheter Blood Stream Infection at a Neonatal Intensive Care Unit: A Retrospective Cohort Study
Sayuri KAWANO1), Koji YONEMOTO2)3) and Tomoko SAKIHAMA4)
1)Department of Patient Safety, Kurume University Hospital, 2)Division of Biostatistics, School of Health Sciences, Faculty of Medicine, University of the Ryukyus, 3)Division of Biostatistics, Advanced Medical Research Center, Faculty of Medicine, University of the Ryukyus, 4)Division of Infection Control and Prevention, Department of Nursing, International University of Health and Welfare Graduate School
Objective: The purpose of this study was to identify the risk factors of peripherally inserted central venous catheter (PICC) -related blood stream infection (BSI) in patients admitted to the neonatal intensive care unit (NICU).
Methods: A retrospective cohort study on NICU patients with a PICC for the first time between January 2008 and December 2015 in Kurume University Hospital. We enrolled 507 patients.
Results: PICC-related BSIs occurred in 40 cases (7.9%), including 33 cases of clinical sepsis, with an incidence rate of 5.9/1000 device days. As potential risk factors of PICC-related BSIs, 12 variables (number of gestational weeks, birth weight, male sex, chromosomal aberrations, congenital heart disease, congenital gastrointestinal disease, catheter insertion site, number of catheter lumens, glove use during insertion, blood transfusion, total parenteral nutrition (TPN), steroid therapy) were identified by univariate logistic regression analyses. Multivariable logistic regression models, which were constructed via a step-by-step modelling procedure considering temporal relationships between those potential risk factors, indicated that male sex, presence of congenital heart disease, low number of gestational weeks, low birth weight, gloveless insertion, and the use of TPN solutions were independent risk factors of PICC-related BSIs. Among them, modifiable factors were gloveless insertion and the use of TPN solutions.
Conclusion: It is important to use gloves as an aseptic technique when PICC is carried out in the NICU. Appropriate use of TPN solutions may help prevent PICC-related BSI.
Key words：Peripherally inserted central venous catheter (PICC), blood stream infection (BSI), neonatal intensive care unit (NICU)
e-mail: kawano_sayuri＠kurume-u.ac.jp
Received: March 27, 2019
Accepted: August 20, 2019
34 (6)：287─295,2019
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