Analysis of Risk Factors of Peripherally Inserted Central Catheter Induced Catheter-related Infection in Patients with Leukemia
Abstract
Background: Peripherally inserted central catheter (PICC) is commonly used in nursing for patients with leukemia. The purpose of this study was to investigate the risk factors of Catheter-related infection (CRI) in patients with leukemia and to provide some nursing strategies based on the results.
Methods: Clinical data from 140 patients with leukemia between May 2014 and July 2016 in Haiyang People's Hospital, China were retrospectively analyzed. We employed univariate analysis to explore the relationship of various factors, including leukemia types, puncture times, underlying diseases, Catheter indwelling time, hormones use, chemotherapy use, immune functions and seasons, with the incidence of CRI. Further, multivariate logistic regression analysis was conducted to identify the potential independent risk factors of CRI. Bacterial culture was performed for etiological detection.
Results: Among the 140 patients with leukemia, 25 cases were diagnosed as CRI, with the incidence of 17.9%. Univariate analysis showed that puncture times, underlying diseases, catheter indwelling time, hormones use, chemotherapy use, immune functions and seasons were significantly correlated with the incidence of CRI. Multivariate logistic regression analysis revealed that immune functions, puncture times and seasons were independent risk factors for CRI. Etiological bacterial culture detected 20 strains of bacteria (Staphylococcus aureus: n=10, Klebsiella pneumonia: n=4, Corynebacterium: n=2 and other species: n=4) in 25 cases diagnosed with CRI.
Conclusion: Based on risk factors of CRI and its etiological distribution, appropriate nursing measures can be taken to reduce the incidence of CRI in patients with leukemia.
Porter DL, Hwang WT, Frey NV et al (2015). Chimeric antigen receptor T cells persist and induce sustained remissions in relapsed refractory chronic lymphocytic leukemia. Sci Transl Med, 7(303):303ra139.
Siegel RL, Miller KD, Jemal A (2016). Cancer statistics, 2016. CA Cancer J Clin, 66(1): 7-30.
Shimoni A, Labopin M, Savani B et al (2016). Long-term survival and late events after allogeneic stem cell transplantation from HLA-matched siblings for acute myeloid leukemia with myeloablative compared to reduced-intensity conditioning: A report on behalf of the acute leukemia working party of European group for blood and marrow transplantation. J Hematol Oncol, 9: 118.
Barrington-Trimis JL, Cockburn M, Metayer C, Gauderman WJ, Wiemels J, McKean-Cowdin R (2016). Trends in Childhood Leukemia Incidence Over Two Decades from 1992-2013. Int J Cancer, 140(5):1000-1008.
Funakoshi T, Latif A, Galsky MD (2013). Risk of hematologic toxicities in patients with solid tumors treated with everolimus: A systematic review and meta-analysis. Crit Rev Oncol Hematol, 88(1): 30-41.
Hershman DL, Lacchetti C, Dworkin RH et al (2014). Prevention and management of chemotherapy-induced peripheral neuropathy in survivors of adult cancers: American Society of Clinical Oncology clinical practice guideline. J Clin Oncol, 32: 1941-1967.
Seto WK, Chan TS, Hwang YY et al (2014). Hepatitis B reactivation in patients with previous hepatitis B virus exposure undergoing rituximab-containing chemotherapy for lymphoma: A prospective study. J Clin Oncol, 32(33): 3736-3743.
Chopra V, Ratz D, Kuhn L, Lopus T, Lee A, Krein S (2014). Peripherally inserted central catheter-related deep vein thrombosis: Contemporary patterns and predictors. J Thromb Haemost, 12(6):847-54.
Itkin M, Mondshein JI, Stavropoulos SW, Shlansky-Goldberg RD, Soulen MC, Trerotola SO (2014). Peripherally inserted central catheter thrombosis--reverse tapered versus nontapered catheters: A randomized controlled study. J Vasc Interv Radiol, 25 (1), 85-91.
Patel GS, Jain K, Kumar R et al (2014). Comparison of peripherally inserted central venous catheters (PICC) versus subcutaneously implanted port-chamber catheters by complication and cost for patients receiving chemotherapy for non-haematological malignancies. Support Care Cancer, 22 (1): 121-128.
Casner M, Hoesli SJ, Slaughter JC, Hill M, Weitkamp JH (2014). Incidence of catheter-related bloodstream infections in neonates following removal of peripherally inserted central venous catheters. Pediatr Crit Care Med, 15: 42-48.
Zhou J, Li M, Tang Z (2014). Peripherally inserted central catheter: How safe is it for acute myeloid leukemia patients? Med Princ Pract, 23(6): 586.
Chopra V, Montoya A, Joshi D et al (2015). Peripherally inserted central catheter use in skilled nursing facilities: A pilot study. J Am Geriatr Soc, 63(9): 1894-1899.
Morano SG, Latagliata R, Girmenia C et al (2015). Catheter-associated bloodstream infections and thrombotic risk in hematologic patients with peripherally inserted central catheters (PICC). Support Care Cancer, 23(11): 3289-3295.
Li J, Fan YY, Xin MZ, Yan J, Hu W, Huang WH, Lin XL, Qin HY (2014). A randomised, controlled trial comparing the long-term effects of peripherally inserted central catheter placement in chemotherapy patients using B-mode ultrasound with modified Seldinger technique versus blind puncture. Eur J Oncol Nurs, 18(1): 94-103.
Kim-Saechao SJ, Almario E, Rubin ZA (2016). A novel infection prevention approach: Leveraging a mandatory electronic communication tool to decrease peripherally inserted central catheter infections, complications, and cost. Am J Infect Control, 44(11): 1335-1345.
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Issue | Vol 46 No 4 (2017) | |
Section | Original Article(s) | |
Keywords | ||
Leukemia Peripherally inserted central catheter (PICC) Catheter-related infection (CRI) Nursing Multi-variate logistic regression |
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