Does the antimicrobial-impregnated peripherally inserted central catheter decrease the CLABSI rate in neonates? Results from a retrospective cohort study
BackgroundThe use of antimicrobial-impregnated peripherally inserted central catheters (PICCs) has been introduced in the last few years to neonatal units aiming to reduce central line-associated bloodstream infection (CLABSI).MethodsThis retrospective observational study aimed to compare the CLABSI...
| Main Authors: | , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2022-11-01
|
| Series: | Frontiers in Pediatrics |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fped.2022.1012800/full |
| _version_ | 1811305299377651712 |
|---|---|
| author | Mohammad A. A. Bayoumi Matheus F. P. T. van Rens Prem Chandra Alaa Masry Sunitha D’Souza Amr M. Khalil Afaf Shadad Safaa Alsayigh Razan M. Masri Sunitha Shyam Sunitha Shyam Fatima Alobaidan Einas E. Elmalik |
| author_facet | Mohammad A. A. Bayoumi Matheus F. P. T. van Rens Prem Chandra Alaa Masry Sunitha D’Souza Amr M. Khalil Afaf Shadad Safaa Alsayigh Razan M. Masri Sunitha Shyam Sunitha Shyam Fatima Alobaidan Einas E. Elmalik |
| author_sort | Mohammad A. A. Bayoumi |
| collection | DOAJ |
| description | BackgroundThe use of antimicrobial-impregnated peripherally inserted central catheters (PICCs) has been introduced in the last few years to neonatal units aiming to reduce central line-associated bloodstream infection (CLABSI).MethodsThis retrospective observational study aimed to compare the CLABSI rates and other catheter-related parameters including the insertion success rates and catheter-related complications in the antimicrobial-impregnated and conventional (ordinary) PICCs in NICU between 2017 and 2020.ResultsOur dedicated PICC team including physicians and nurses inserted 1,242 conventional (PremiCath and NutriLine) and 791 antimicrobial-impregnated PICCs (PremiStar) over the study period from 2017 to 2020. Of those 1,242 conventional PICCs, 1,171 (94.3%) were 1 Fr single lumen and only 71 (5.7%) were 2 Fr double lumen. The mean ± SD [median (IQR)] for the birth weight in all babies who had a PICC line was 1,343.3 ± 686.75 [1,200 (900, 1,500)] g, while the mean ± SD for the gestational age was 29.6 ± 4.03 [29 (27, 31)] weeks. The mean ± SD [median (IQR)] age at the time of insertion for all catheters was 9.3 ± 21.47 [2 (1, 9)] days, while the mean ± SD [median (IQR)] dwell time was 15.7 ± 14.03 [12 (8, 17)] days. The overall success rate of the PICC insertion is 1,815/2,033 (89.3%), while the first attempt success rate is 1,290/2,033 (63.5%). The mean ± SD [median (IQR)] gestational age, birth weight, age at catheter insertion, and catheter dwell time were 28.8 ± 3.24 [29, (26, 31)] weeks, 1,192.1 ± 410.3 [1,150, (900, 1,450)] g, 6.3 ± 10.85 [2, (1, 8)] days, and 17.73 ± 17.532 [13, (9, 18)] days in the antimicrobial-impregnated catheter compared with 30.1 ± 4.39 [29, (27, 32)] weeks (P < 0.001), 1,439.5 ± 800.8 [1,240, (920, 1,520)] g (P < 0.001), 11.1 ± 25.9 [1, (1, 9)] days (P < 0.001), and 14.30 ± 10.964 [12, (8, 17)] days (P < 0.001), respectively, in the conventional PICCs. The use of the antimicrobial-impregnated catheter was not associated with any significant reduction in the CLABSI rate (per 1,000 days dwell time), either the overall [P = 0.11, risk ratio (RR) (95% CI): 0.60 (0.32, 1.13)] or the yearly CLABSI rates.ConclusionsThe use of miconazole and rifampicin-impregnated PICCs did not reduce the CLABSI rate in neonates compared with conventional PICCs. However, it has a higher overall rate of elective removal after completion of therapy and less extravasation/infiltration, occlusion, and phlebitis compared with the conventional PICCs. Further large RCTs are recommended to enrich the current paucity of evidence and to reduce the risk of bias. Neonatal PICCs impregnation by other antimicrobials is a recommendation for vascular access device manufacturers. |
| first_indexed | 2024-04-13T08:24:03Z |
| format | Article |
| id | doaj.art-ec4df0b8012a484aaf06147fa464851a |
| institution | Directory Open Access Journal |
| issn | 2296-2360 |
| language | English |
| last_indexed | 2024-04-13T08:24:03Z |
| publishDate | 2022-11-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pediatrics |
| spelling | doaj.art-ec4df0b8012a484aaf06147fa464851a2022-12-22T02:54:34ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602022-11-011010.3389/fped.2022.10128001012800Does the antimicrobial-impregnated peripherally inserted central catheter decrease the CLABSI rate in neonates? Results from a retrospective cohort studyMohammad A. A. Bayoumi0Matheus F. P. T. van Rens1Prem Chandra2Alaa Masry3Sunitha D’Souza4Amr M. Khalil5Afaf Shadad6Safaa Alsayigh7Razan M. Masri8Sunitha Shyam9Sunitha Shyam10Fatima Alobaidan11Einas E. Elmalik12Neonatal Intensive Care Unit (NICU), Women’s Wellness and Research Center (WWRC), Hamad Medical Corporation (HMC), Doha, QatarNeonatal Intensive Care Unit (NICU), Women’s Wellness and Research Center (WWRC), Hamad Medical Corporation (HMC), Doha, QatarMedical Research Center, Hamad Medical Corporation (HMC), Doha, QatarNeonatal Intensive Care Unit (NICU), Women’s Wellness and Research Center (WWRC), Hamad Medical Corporation (HMC), Doha, QatarNeonatal Intensive Care Unit (NICU), Women’s Wellness and Research Center (WWRC), Hamad Medical Corporation (HMC), Doha, QatarNeonatal Intensive Care Unit (NICU), Women’s Wellness and Research Center (WWRC), Hamad Medical Corporation (HMC), Doha, QatarNeonatal Intensive Care Unit (NICU), Women’s Wellness and Research Center (WWRC), Hamad Medical Corporation (HMC), Doha, QatarNeonatal Intensive Care Unit (NICU), Women’s Wellness and Research Center (WWRC), Hamad Medical Corporation (HMC), Doha, QatarDepartment of Medical Education, Hamad Medical Corporation (HMC), Doha, QatarNeonatal Intensive Care Unit (NICU), Women’s Wellness and Research Center (WWRC), Hamad Medical Corporation (HMC), Doha, QatarVERITADYNE Strategic Consulting Pvt. Ltd., Delhi, IndiaNeonatal Intensive Care Unit (NICU), Women’s Wellness and Research Center (WWRC), Hamad Medical Corporation (HMC), Doha, QatarNeonatal Intensive Care Unit (NICU), Women’s Wellness and Research Center (WWRC), Hamad Medical Corporation (HMC), Doha, QatarBackgroundThe use of antimicrobial-impregnated peripherally inserted central catheters (PICCs) has been introduced in the last few years to neonatal units aiming to reduce central line-associated bloodstream infection (CLABSI).MethodsThis retrospective observational study aimed to compare the CLABSI rates and other catheter-related parameters including the insertion success rates and catheter-related complications in the antimicrobial-impregnated and conventional (ordinary) PICCs in NICU between 2017 and 2020.ResultsOur dedicated PICC team including physicians and nurses inserted 1,242 conventional (PremiCath and NutriLine) and 791 antimicrobial-impregnated PICCs (PremiStar) over the study period from 2017 to 2020. Of those 1,242 conventional PICCs, 1,171 (94.3%) were 1 Fr single lumen and only 71 (5.7%) were 2 Fr double lumen. The mean ± SD [median (IQR)] for the birth weight in all babies who had a PICC line was 1,343.3 ± 686.75 [1,200 (900, 1,500)] g, while the mean ± SD for the gestational age was 29.6 ± 4.03 [29 (27, 31)] weeks. The mean ± SD [median (IQR)] age at the time of insertion for all catheters was 9.3 ± 21.47 [2 (1, 9)] days, while the mean ± SD [median (IQR)] dwell time was 15.7 ± 14.03 [12 (8, 17)] days. The overall success rate of the PICC insertion is 1,815/2,033 (89.3%), while the first attempt success rate is 1,290/2,033 (63.5%). The mean ± SD [median (IQR)] gestational age, birth weight, age at catheter insertion, and catheter dwell time were 28.8 ± 3.24 [29, (26, 31)] weeks, 1,192.1 ± 410.3 [1,150, (900, 1,450)] g, 6.3 ± 10.85 [2, (1, 8)] days, and 17.73 ± 17.532 [13, (9, 18)] days in the antimicrobial-impregnated catheter compared with 30.1 ± 4.39 [29, (27, 32)] weeks (P < 0.001), 1,439.5 ± 800.8 [1,240, (920, 1,520)] g (P < 0.001), 11.1 ± 25.9 [1, (1, 9)] days (P < 0.001), and 14.30 ± 10.964 [12, (8, 17)] days (P < 0.001), respectively, in the conventional PICCs. The use of the antimicrobial-impregnated catheter was not associated with any significant reduction in the CLABSI rate (per 1,000 days dwell time), either the overall [P = 0.11, risk ratio (RR) (95% CI): 0.60 (0.32, 1.13)] or the yearly CLABSI rates.ConclusionsThe use of miconazole and rifampicin-impregnated PICCs did not reduce the CLABSI rate in neonates compared with conventional PICCs. However, it has a higher overall rate of elective removal after completion of therapy and less extravasation/infiltration, occlusion, and phlebitis compared with the conventional PICCs. Further large RCTs are recommended to enrich the current paucity of evidence and to reduce the risk of bias. Neonatal PICCs impregnation by other antimicrobials is a recommendation for vascular access device manufacturers.https://www.frontiersin.org/articles/10.3389/fped.2022.1012800/fullvascular accessvascular access devicesperipherally inserted central catheterantimicrobial-impregnated central venous catheterscentral line-associated bloodstream infectionnewborn |
| spellingShingle | Mohammad A. A. Bayoumi Matheus F. P. T. van Rens Prem Chandra Alaa Masry Sunitha D’Souza Amr M. Khalil Afaf Shadad Safaa Alsayigh Razan M. Masri Sunitha Shyam Sunitha Shyam Fatima Alobaidan Einas E. Elmalik Does the antimicrobial-impregnated peripherally inserted central catheter decrease the CLABSI rate in neonates? Results from a retrospective cohort study Frontiers in Pediatrics vascular access vascular access devices peripherally inserted central catheter antimicrobial-impregnated central venous catheters central line-associated bloodstream infection newborn |
| title | Does the antimicrobial-impregnated peripherally inserted central catheter decrease the CLABSI rate in neonates? Results from a retrospective cohort study |
| title_full | Does the antimicrobial-impregnated peripherally inserted central catheter decrease the CLABSI rate in neonates? Results from a retrospective cohort study |
| title_fullStr | Does the antimicrobial-impregnated peripherally inserted central catheter decrease the CLABSI rate in neonates? Results from a retrospective cohort study |
| title_full_unstemmed | Does the antimicrobial-impregnated peripherally inserted central catheter decrease the CLABSI rate in neonates? Results from a retrospective cohort study |
| title_short | Does the antimicrobial-impregnated peripherally inserted central catheter decrease the CLABSI rate in neonates? Results from a retrospective cohort study |
| title_sort | does the antimicrobial impregnated peripherally inserted central catheter decrease the clabsi rate in neonates results from a retrospective cohort study |
| topic | vascular access vascular access devices peripherally inserted central catheter antimicrobial-impregnated central venous catheters central line-associated bloodstream infection newborn |
| url | https://www.frontiersin.org/articles/10.3389/fped.2022.1012800/full |
| work_keys_str_mv | AT mohammadaabayoumi doestheantimicrobialimpregnatedperipherallyinsertedcentralcatheterdecreasetheclabsirateinneonatesresultsfromaretrospectivecohortstudy AT matheusfptvanrens doestheantimicrobialimpregnatedperipherallyinsertedcentralcatheterdecreasetheclabsirateinneonatesresultsfromaretrospectivecohortstudy AT premchandra doestheantimicrobialimpregnatedperipherallyinsertedcentralcatheterdecreasetheclabsirateinneonatesresultsfromaretrospectivecohortstudy AT alaamasry doestheantimicrobialimpregnatedperipherallyinsertedcentralcatheterdecreasetheclabsirateinneonatesresultsfromaretrospectivecohortstudy AT sunithadsouza doestheantimicrobialimpregnatedperipherallyinsertedcentralcatheterdecreasetheclabsirateinneonatesresultsfromaretrospectivecohortstudy AT amrmkhalil doestheantimicrobialimpregnatedperipherallyinsertedcentralcatheterdecreasetheclabsirateinneonatesresultsfromaretrospectivecohortstudy AT afafshadad doestheantimicrobialimpregnatedperipherallyinsertedcentralcatheterdecreasetheclabsirateinneonatesresultsfromaretrospectivecohortstudy AT safaaalsayigh doestheantimicrobialimpregnatedperipherallyinsertedcentralcatheterdecreasetheclabsirateinneonatesresultsfromaretrospectivecohortstudy AT razanmmasri doestheantimicrobialimpregnatedperipherallyinsertedcentralcatheterdecreasetheclabsirateinneonatesresultsfromaretrospectivecohortstudy AT sunithashyam doestheantimicrobialimpregnatedperipherallyinsertedcentralcatheterdecreasetheclabsirateinneonatesresultsfromaretrospectivecohortstudy AT sunithashyam doestheantimicrobialimpregnatedperipherallyinsertedcentralcatheterdecreasetheclabsirateinneonatesresultsfromaretrospectivecohortstudy AT fatimaalobaidan doestheantimicrobialimpregnatedperipherallyinsertedcentralcatheterdecreasetheclabsirateinneonatesresultsfromaretrospectivecohortstudy AT einaseelmalik doestheantimicrobialimpregnatedperipherallyinsertedcentralcatheterdecreasetheclabsirateinneonatesresultsfromaretrospectivecohortstudy |