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

Yu Mi Lee, Byung Han Ryu, Sun In Hong, Oh Hyun Cho, Kyung Wook Hong, In Gyu Bae, Won Gun Kwack, Young Jin Kim, Eun Kyoung Chung, Dong Youn Kim, Mi Suk Lee, Ki Ho Park

Research output: Contribution to journalArticlepeer-review

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.

Original languageEnglish
Pages (from-to)162-168
Number of pages7
JournalInfection Control and Hospital Epidemiology
Volume42
Issue number2
DOIs
Publication statusPublished - Feb 2021

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