ISR 68 - Peripheral Venous Catheter Associated Bloodstream Infections (PVC-BSI) Risk Compared to Central Line Associated Bloodstream Infections (CLABSI)

Background: Approximately 200 million peripheral venous catheters (PVCs) are used each year on adults in the United States. Overall, the risk of catheter-related bloodstream infections (BSIs) has been reported to be greater in central venous catheters (CVCs) than PVCs, but CVCs are used less frequently in acute care settings compared to PVCs. The objective of this study was to compare the risk of peripheral venous catheter bloodstream infection (PVC-BSI) to central line associated bloodstream (CLABSI).

Methods: A case control study was conducted at a quaternary care academic health system. A patient line list was generated from EPIC ® electronic medical records (EMR) with an eligible PVC identified using the same CLABSI definitions from the National Healthcare Safety Network (NHSN), between December 2020 and August 2021. Rates of devices, odds ratios (OR) and 95% confidence intervals (CI) were calculated for risk of anatomical PVC locations including antecubital, wrist, forearm, overall flexure and PVC dwell time less than 96 hours using R 4.1.3 Epidemiology Tools package, version 0.5-10.1.

Results: During the study period, 12 (1.7%) healthcare associated infection PVC-BSI cases were identified from the 703 patients with bacteremia. Of the 12-hospital onset (HO) Methicillin-resistant Staphylococcus aureus (MRSA) bacteremia reported, 4 were PVC related (2 PVC-BSI and 2 CLABSI with PVCs in place). The rate of CLABSI was significantly higher than the rate of PVC per 1000-line days (p=0.015). All anatomical locations of PVCs were not statistically significant. PVC dwell time greater than 96 hours were 5.48 times more likely to have a PVC-BSI.

Conclusions: This study found that PVC-BSIs were responsible for the majority of vascular access associated Staphylococcus aureus bacteremia. Developing a PVC-BSI surveillance program in an EMR system for active surveillance is achievable in hospitals, including facilities with low resources. Data obtained can be used to prevent HO bacteremia with highly pathogenic organisms.