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Clinical impact of early reinsertion of a central venous catheter after catheter removal in patients with catheter-related bloodstream infections

Published online by Cambridge University Press:  09 September 2020

Yu-Mi Lee
Affiliation:
Division of Infectious Diseases, Department of Internal Medicine, Kyung Hee University Hospital, Kyung Hee University School of Medicine, Seoul, Republic of Korea
Byung-Han Ryu
Affiliation:
Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea
Sun In Hong
Affiliation:
Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea
Oh-Hyun Cho
Affiliation:
Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea
Kyung-Wook Hong
Affiliation:
Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Jinju, Republic of Korea
In-Gyu Bae
Affiliation:
Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Jinju, Republic of Korea
Won Gun Kwack
Affiliation:
Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Kyung Hee University Hospital, Seoul, Republic of Korea
Young Jin Kim
Affiliation:
Department of Laboratory Medicine, Kyung Hee University Hospital, Kyung Hee University School of Medicine, Seoul, Republic of Korea
Eun Kyoung Chung
Affiliation:
Department of Pharmacy, College of Pharmacy, Kyung Hee University, Seoul, Republic of Korea
Dong Youn Kim
Affiliation:
Division of Infectious Diseases, Department of Internal Medicine, Kyung Hee University Hospital, Kyung Hee University School of Medicine, Seoul, Republic of Korea
Mi Suk Lee
Affiliation:
Division of Infectious Diseases, Department of Internal Medicine, Kyung Hee University Hospital, Kyung Hee University School of Medicine, Seoul, Republic of Korea
Ki-Ho Park*
Affiliation:
Division of Infectious Diseases, Department of Internal Medicine, Kyung Hee University Hospital, Kyung Hee University School of Medicine, Seoul, Republic of Korea
*
Author for correspondence: Ki-Ho Park, E-mail: parkkiho@hotmail.com

Abstract

Objective:

Early replacement of a new central venous catheter (CVC) may pose a risk of persistent or recurrent infection in patients with a catheter-related bloodstream infection (CRBSI). We evaluated the clinical impact of early CVC reinsertion after catheter removal in patients with CRBSIs.

Methods:

We conducted a retrospective chart review of adult patients with confirmed CRBSIs in 2 tertiary-care hospitals over a 7-year period.

Results:

To treat their infections, 316 patients with CRBSIs underwent CVC removal. Among them, 130 (41.1%) underwent early CVC reinsertion (≤3 days after CVC removal), 39 (12.4%) underwent delayed reinsertion (>3 days), and 147 (46.5%) did not undergo CVC reinsertion. There were no differences in baseline characteristics among the 3 groups, except for nontunneled CVC, presence of septic shock, and reason for CVC reinsertion. The rate of persistent CRBSI in the early CVC reinsertion group (22.3%) was higher than that in the no CVC reinsertion group (7.5%; P = .002) but was similar to that in the delayed CVC reinsertion group (17.9%; P > .99). The other clinical outcomes did not differ among the 3 groups, including rates of 30-day mortality, complicated infection, and recurrence. After controlling for several confounding factors, early CVC reinsertion was not significantly associated with persistent CRBSI (OR, 1.59; P = .35) or 30-day mortality compared with delayed CVC reinsertion (OR, 0.81; P = .68).

Conclusions:

Early CVC reinsertion in the setting of CRBSI may be safe. Replacement of a new CVC should not be delayed in patients who still require a CVC for ongoing management.

Type
Original Article
Copyright
© 2020 by The Society for Healthcare Epidemiology of America. All rights reserved.

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Footnotes

a

First authors of equal contribution.

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