Correlation of Positive Blood Cultures with Peripherally Inserted Central Catheter Line Infection in Oncology Patients

Abstract

Introduction: The use of peripherally inserted central catheter (PICC) lines offers several advantages compared to traditional central venous catheters (CVCs) as the insertion procedure is minimally invasive, they may be retained safely for longer periods of time, and their use is associated with fewer catheter-related infections. Their use in patients suffering from a malignant disease is common but may pose a greater risk of complications due to the severe immunosuppression associated with treatment. This study was conducted to evaluate the safety of PICC lines in this group.

Methods: This was a retrospective study of oncology patients being treated in a Mediterranean tertiary center. Patients with PICC lines were enrolled in the study if a positive blood culture necessitated the removal of the PICC and subsequent culture of the PICC tip. A comparison was conducted between patients with positive and negative PICC cultures.

Results: Thirty patients were included, four of whom had a positive PICC culture. The most commonly isolated pathogens were coagulase-negative Staphylococci and Corynebacteria. No statistically significant difference was noted in white blood cell (WBC) counts, C-reactive protein (CRP), and Michigan PICC central line associated bloodstream infection (MPC) score between the two groups. Staphylococcus epidermidis was the most commonly isolated pathogen.

Discussion: Though limited by a small sample size and the retrospective design, the findings of this study seem to corroborate existing literature on the subject which suggests that the use of PICC lines in oncology patients is feasible and does not pose unacceptable risk. Further research is indicated to determine subgroups which may be at greater risk of PICC related infections.

Keywords: central line-associated infections (clabsi); central venous catheter; coagulase-negative staphylococci; critical care; febrile neutropenia; infection; picc; sepsis.