Objective:

To compare catheter related blood stream infection (CRBSI) rate between cuffed tunnelled and non-cuffed tunnelled PICC.

Methods:

We prospectively followed 100 patients (50:50 cuffed and non-cuffed PICC) and compared CRBSI rate between these groups. Daily review and similar catheter care were performed until a PICC-related complication, completion of therapy, death or defined end-of-study date necessitate removal. CRBSI was confirmed in each case by demonstrating concordance between isolates colonizing the PICC at the time of infection and from peripheral blood cultures.

Results:

A total of 50 cuffed PICC were placed for 1864 catheter-days. Of these, 12 patients (24%) developed infection, for which 5 patients (10%) had a CRBSI for a rate of 2.7 per 1000 catheter-days. Another 50 tunnelled non-cuffed PICCs were placed for 2057 catheter-days. Of these, 7 patients (14%) developed infection, for which 3 patients (6%) had a CRBSI. for a rate of 1.5 per 1000 catheter-days. The mean time to development of infection is 24 days in cuffed and 19 days in non-cuffed groups. The mean duration of utilization was significantly longer in non-cuffed than in cuffed group (43 days in non-cuffed vs 37 days in cuffed group, p = 0.008).

Conclusions:

Cuffed PICC does not further reduce the rate of local or bloodstream infection. Tunnelled non-cuffed PICC is shown to be as effective if not better at reducing risk of CRBSI and providing longer catheter dwell time compared to cuffed PICC.

中文翻译：

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带袖套的隧道式和不带袖套的隧道式外周插入中心导管的导管相关血流感染率比较

客观的：

比较带套囊隧道式和非套囊隧道式 PICC 的导管相关血流感染 (CRBSI) 率。

方法：

我们前瞻性地跟踪了 100 名患者（50:50 的袖带和非袖带 PICC），并比较了这些组之间的 CRBSI 发生率。进行每日检查和类似的导管护理，直到出现 PICC 相关并发症、完成治疗、死亡或确定的研究结束日期需要移除为止。通过证明感染时 PICC 定植的分离株与外周血培养结果的一致性，在每种情况下都证实了 CRBSI。

结果：

总共放置了 50 个带袖套的 PICC，共放置了 1864 个导管日。其中，12 名患者 (24%) 发生感染，其中 5 名患者 (10%) 发生 CRBSI，发生率为 2.7/1000 导管日。另外 50 个隧道式无袖套 PICC 放置了 2057 个导管日。其中，7 名患者 (14%) 发生感染，其中 3 名患者 (6%) 患有 CRBSI。为每 1000 导管日 1.5 次。感染发展的平均时间是袖带组 24 天和非袖带组 19 天。非袖带组的平均使用时间显着长于袖带组（非袖带组 43 天 vs 袖带组 37 天，p  = 0.008）。

结论：

带袖套的 PICC 不会进一步降低局部或血流感染率。与带袖套的 PICC 相比，带隧道的无袖套 PICC 在降低 CRBSI 风险和提供更长的导管停留时间方面表现出同样的效果。