Are antimicrobial peripherally inserted central catheters associated with reduction in central line-associated bloodstream infection? A systematic review and meta-analysis. Kramer R.D., Rogers M.A.M., Conte M., Mann J., Saint S., & Chopra V. 2017. ![Are antimicrobial peripherally inserted central catheters associated with reduction in central line-associated bloodstream infection? A systematic review and meta-analysis [link]](https://bibbase.org/img/filetypes/link.svg "link")
Paper abstract bibtex Background Antimicrobial peripherally inserted central catheters (PICCs) may reduce the risk of central line-associated bloodstream infection (CLABSI). However, data regarding efficacy are limited. We aimed to evaluate whether antimicrobial PICCs are associated with CLABSI reduction. Methods MEDLINE, EMBASE, CINHAL, and Web of Science were searched from inception to July 2016; conference proceedings were searched to identify additional studies. Study selection and data extraction were performed independently by 2 authors. Results Of 597 citations identified, 8 studies involving 12,879 patients met eligibility criteria. Studies included adult and pediatric patients from intensive care, long-term care, and general ward settings. The incidence of CLABSI in patients with antimicrobial PICCs was 0.2% (95% confidence interval [CI], 0.0%-0.5%), and the incidence among nonantimicrobial catheters was 5.3% (95% CI, 2.6%-8.8%). Compared with noncoated PICCs, antimicrobial PICCs were associated with a significant reduction in CLABSI (relative risk [RR],0.29; 95% CI, 0.10-0.78). Statistical heterogeneity (I2,71.6%; T2=1.07) was resolved by publication type, with peer-reviewed articles showing greater reduction in CLABSI (RR,0.21; 95% CI, 0.06-0.74). Twenty-six patients (95% CI, 21-75) need to be treated with antimicrobial PICCs to prevent 1 CLABSI. Studies of adults at greater baseline risk of CLABSI experienced greater reduction in CLABSI (RR, 0.20; P=.003). Conclusions Available evidence suggests that antimicrobial PICCs may reduce CLABSI, especially in high-risk subgroups. Randomized trials are needed to assess efficacy across patient populations. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc.
@misc{kramer_r.d._are_2017,
title = {Are antimicrobial peripherally inserted central catheters associated with reduction in central line-associated bloodstream infection? {A} systematic review and meta-analysis},
url = {http://www.journals.elsevier.com/ajic-american-journal-of-infection-control/},
abstract = {Background Antimicrobial peripherally inserted central catheters (PICCs) may reduce the risk of central line-associated bloodstream infection (CLABSI). However, data regarding efficacy are limited. We aimed to evaluate whether antimicrobial PICCs are associated with CLABSI reduction. Methods MEDLINE, EMBASE, CINHAL, and Web of Science were searched from inception to July 2016; conference proceedings were searched to identify additional studies. Study selection and data extraction were performed independently by 2 authors. Results Of 597 citations identified, 8 studies involving 12,879 patients met eligibility criteria. Studies included adult and pediatric patients from intensive care, long-term care, and general ward settings. The incidence of CLABSI in patients with antimicrobial PICCs was 0.2\% (95\% confidence interval [CI], 0.0\%-0.5\%), and the incidence among nonantimicrobial catheters was 5.3\% (95\% CI, 2.6\%-8.8\%). Compared with noncoated PICCs, antimicrobial PICCs were associated with a significant reduction in CLABSI (relative risk [RR],0.29; 95\% CI, 0.10-0.78). Statistical heterogeneity (I2,71.6\%; T2=1.07) was resolved by publication type, with peer-reviewed articles showing greater reduction in CLABSI (RR,0.21; 95\% CI, 0.06-0.74). Twenty-six patients (95\% CI, 21-75) need to be treated with antimicrobial PICCs to prevent 1 CLABSI. Studies of adults at greater baseline risk of CLABSI experienced greater reduction in CLABSI (RR, 0.20; P=.003). Conclusions Available evidence suggests that antimicrobial PICCs may reduce CLABSI, especially in high-risk subgroups. Randomized trials are needed to assess efficacy across patient populations. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc.},
journal = {American Journal of Infection Control},
author = {{Kramer R.D.} and {Rogers M.A.M.} and {Conte M.} and {Mann J.} and {Saint S.} and {Chopra V.}},
year = {2017},
keywords = {*adverse device effect, *antiinfective agent, *antiinfective agent/dt [Drug Therapy], *antimicrobial catheter, *antimicrobial catheter/am [Adverse Device Effect], *antimicrobial therapy, *catheter infection, *catheter infection/co [Complication], *catheter infection/dt [Drug Therapy], *catheter infection/pc [Prevention], *infection prevention, *peripherally inserted central venous catheter, *peripherally inserted central venous catheter/am [Adverse Device Effect], *vein, Child, Cinahl, Embase, Medline, Web of Science, adult, article, catheter infection/dt [Drug Therapy], comparative effectiveness, confidence interval, controlled clinical trial, controlled clinical trial (topic), controlled study, data extraction, disease association, drug therapy, evidence based practice, human, incidence, infection prevention, intensive care, long term care, meta analysis, pediatrics, peer review, prevention, publication, randomized controlled trial, randomized controlled trial(topic), risk factor, risk reduction, systematic review, ward}
}
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A systematic review and meta-analysis","url":"http://www.journals.elsevier.com/ajic-american-journal-of-infection-control/","abstract":"Background Antimicrobial peripherally inserted central catheters (PICCs) may reduce the risk of central line-associated bloodstream infection (CLABSI). However, data regarding efficacy are limited. We aimed to evaluate whether antimicrobial PICCs are associated with CLABSI reduction. Methods MEDLINE, EMBASE, CINHAL, and Web of Science were searched from inception to July 2016; conference proceedings were searched to identify additional studies. Study selection and data extraction were performed independently by 2 authors. Results Of 597 citations identified, 8 studies involving 12,879 patients met eligibility criteria. Studies included adult and pediatric patients from intensive care, long-term care, and general ward settings. The incidence of CLABSI in patients with antimicrobial PICCs was 0.2% (95% confidence interval [CI], 0.0%-0.5%), and the incidence among nonantimicrobial catheters was 5.3% (95% CI, 2.6%-8.8%). Compared with noncoated PICCs, antimicrobial PICCs were associated with a significant reduction in CLABSI (relative risk [RR],0.29; 95% CI, 0.10-0.78). Statistical heterogeneity (I2,71.6%; T2=1.07) was resolved by publication type, with peer-reviewed articles showing greater reduction in CLABSI (RR,0.21; 95% CI, 0.06-0.74). Twenty-six patients (95% CI, 21-75) need to be treated with antimicrobial PICCs to prevent 1 CLABSI. Studies of adults at greater baseline risk of CLABSI experienced greater reduction in CLABSI (RR, 0.20; P=.003). Conclusions Available evidence suggests that antimicrobial PICCs may reduce CLABSI, especially in high-risk subgroups. Randomized trials are needed to assess efficacy across patient populations. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc.","journal":"American Journal of Infection Control","author":[{"firstnames":[],"propositions":[],"lastnames":["Kramer R.D."],"suffixes":[]},{"firstnames":[],"propositions":[],"lastnames":["Rogers M.A.M."],"suffixes":[]},{"firstnames":[],"propositions":[],"lastnames":["Conte M."],"suffixes":[]},{"firstnames":[],"propositions":[],"lastnames":["Mann J."],"suffixes":[]},{"firstnames":[],"propositions":[],"lastnames":["Saint S."],"suffixes":[]},{"firstnames":[],"propositions":[],"lastnames":["Chopra V."],"suffixes":[]}],"year":"2017","keywords":"*adverse device effect, *antiinfective agent, *antiinfective agent/dt [Drug Therapy], *antimicrobial catheter, *antimicrobial catheter/am [Adverse Device Effect], *antimicrobial therapy, *catheter infection, *catheter infection/co [Complication], *catheter infection/dt [Drug Therapy], *catheter infection/pc [Prevention], *infection prevention, *peripherally inserted central venous catheter, *peripherally inserted central venous catheter/am [Adverse Device Effect], *vein, Child, Cinahl, Embase, Medline, Web of Science, adult, article, catheter infection/dt [Drug Therapy], comparative effectiveness, confidence interval, controlled clinical trial, controlled clinical trial (topic), controlled study, data extraction, disease association, drug therapy, evidence based practice, human, incidence, infection prevention, intensive care, long term care, meta analysis, pediatrics, peer review, prevention, publication, randomized controlled trial, randomized controlled trial(topic), risk factor, risk reduction, systematic review, ward","bibtex":"@misc{kramer_r.d._are_2017,\n\ttitle = {Are antimicrobial peripherally inserted central catheters associated with reduction in central line-associated bloodstream infection? {A} systematic review and meta-analysis},\n\turl = {http://www.journals.elsevier.com/ajic-american-journal-of-infection-control/},\n\tabstract = {Background Antimicrobial peripherally inserted central catheters (PICCs) may reduce the risk of central line-associated bloodstream infection (CLABSI). However, data regarding efficacy are limited. We aimed to evaluate whether antimicrobial PICCs are associated with CLABSI reduction. Methods MEDLINE, EMBASE, CINHAL, and Web of Science were searched from inception to July 2016; conference proceedings were searched to identify additional studies. Study selection and data extraction were performed independently by 2 authors. Results Of 597 citations identified, 8 studies involving 12,879 patients met eligibility criteria. Studies included adult and pediatric patients from intensive care, long-term care, and general ward settings. The incidence of CLABSI in patients with antimicrobial PICCs was 0.2\\% (95\\% confidence interval [CI], 0.0\\%-0.5\\%), and the incidence among nonantimicrobial catheters was 5.3\\% (95\\% CI, 2.6\\%-8.8\\%). Compared with noncoated PICCs, antimicrobial PICCs were associated with a significant reduction in CLABSI (relative risk [RR],0.29; 95\\% CI, 0.10-0.78). Statistical heterogeneity (I2,71.6\\%; T2=1.07) was resolved by publication type, with peer-reviewed articles showing greater reduction in CLABSI (RR,0.21; 95\\% CI, 0.06-0.74). Twenty-six patients (95\\% CI, 21-75) need to be treated with antimicrobial PICCs to prevent 1 CLABSI. Studies of adults at greater baseline risk of CLABSI experienced greater reduction in CLABSI (RR, 0.20; P=.003). Conclusions Available evidence suggests that antimicrobial PICCs may reduce CLABSI, especially in high-risk subgroups. Randomized trials are needed to assess efficacy across patient populations. 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