Risk factors and clinical analysis of peripherally inserted central catheter-related fungal colonization in premature infants

• Published in: Scientific reports Vol. 11; no. 1; p. 20897
• Main Authors: Zhang, Lingping, Yang, Liu, Dong, Wenbin, Liu, Xingling, Lei, Xiaoping, Zhang, Lianyu
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 22.10.2021; Nature Publishing Group; Nature Portfolio
• Subjects: 692/308/3187; 692/700/1720/3185; Antibiotics; Birth weight; Birth Weight - physiology; Catheter-Related Infections - etiology; Catheter-Related Infections - microbiology; Catheterization, Central Venous - adverse effects; Catheterization, Peripheral - adverse effects; Catheters; Catheters, Indwelling - adverse effects; Colonization; Demography; Female; Fungemia; Gestational Age; Glucocorticoids; Humanities and Social Sciences; Humans; Infant, Newborn; Infant, Premature; Infant, Premature, Diseases - etiology; Infant, Premature, Diseases - microbiology; Infants; Male; Medical instruments; multidisciplinary; Neonates; Nutrition; Odds Ratio; Parenteral nutrition; Parenteral Nutrition - methods; Parenteral Nutrition, Total - methods; Premature babies; Premature birth; Risk Factors; Science; Science (multidisciplinary)
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-021-00120-0

We aimed to analyze the risk factors of positive peripherally inserted central catheter (PICC)-related fungal colonization in preterm infants. This retrospective study collected data from 2018 to 2020. The enrolled infants who underwent PICC insertion were born at < 32 weeks’ gestation or birth weight < 1500 g. The demographics, PICC-related characteristics, and treatment information were collected. Univariate and multivariate analyses were performed to investigate risk factors for PICC-related fungal colonization. The receiver operating characteristic (ROC) curve was used to determine the optimal cut-off values for the duration of antibiotics and parenteral nutrition. In total, 124 premature infants underwent PICC insertion. Among them, 19 patients had positive results of fungi on the PICC tips. The duration of antibiotics (odds ratio [OR] 1.16, 95% confidence interval [CI] 1.02–1.31), parenteral nutrition infusion (OR 1.27, 95% CI 1.05–1.54), and postnatal glucocorticoid exposure (OR 9.48, 95% CI 1.06–84.98) were independent risk factors for fungal colonization in PICCs. The ROC curves showed that the risk increased after 15 days of antibiotic use and 28 days of parenteral nutrition infusion. Appropriate clinical management should be used to prevent fungal colonization and fungemia.