Peripheral intravenous catheter-associated Staphylococcus aureus bacteraemia: more than 5 years of prospective data from two tertiary health services

Rhonda L Stuart, Donna R M Cameron, Carmel Scott, Despina Kotsanas, M Lindsay Grayson, Tony M Korman, Elizabeth E Gillespie and Paul D R Johnson
Med J Aust 2013; 198 (10): 551-553. || doi: 10.5694/mja12.11699


Objectives: To determine the incidence, risk factors for and outcomes of Staphylococcus aureus bacteraemia (SAB) associated with peripheral intravenous catheters (PIVCs).

Design, setting and patients: A review of prospectively collected data from two tertiary health services on all health care-associated SAB episodes occurring in adults aged > 17 years from January 2007 to July 2012.

Main outcome measures: Numbers of health care-associated SAB episodes; device type, location of insertion, device dwell time and outcome at 7 and 30 days for all SAB episodes associated with use of a PIVC; rates of SAB per 10 000 occupied bed-days (OBDs).

Results: Overall, 137 of 583 health care-associated-SAB episodes (23.5%) were deemed to be PIVC associated, with an incidence of 0.26/10 000 OBD. The mean dwell time for PIVCs was 3.5 days (range, 0.25–9 days) and 45.2% of SABs occurred in PIVCs with a dwell time ≥ 4 days. Of the PIVC-associated SAB episodes, 39.6% involved PIVCs inserted in the ED, 39.6% involved PIVCs inserted on wards and 20.8% involved PIVCs inserted by the ambulance service. Of the PIVC-associated SABs occurring within 4 days of insertion, 61% were inserted by ED staff or the ambulance service. PIVC-associated SAB were associated with a 30-day all-cause mortality rate of 26.5%.

Conclusion: PIVC-associated SAB is an under-recognised complication. The high incidences of SAB associated with PIVCs inserted in emergency locations and with prolonged dwell times support recommendations in clinical guidelines for routine removal of PIVCs.

  • Rhonda L Stuart1,2
  • Donna R M Cameron3
  • Carmel Scott4
  • Despina Kotsanas1
  • M Lindsay Grayson3,5
  • Tony M Korman1,2
  • Elizabeth E Gillespie4
  • Paul D R Johnson3,5

  • 1 Monash Infectious Diseases, Monash Health, Melbourne, VIC.
  • 2 Department of Medicine, Southern Clinical School, Monash University, Melbourne, VIC.
  • 3 Department of Infectious Diseases, Austin Health, Melbourne, VIC.
  • 4 Infection Control and Epidemiology, Monash Medical Centre, Monash Health, Melbourne, VIC.
  • 5 Department of Medicine, University of Melbourne, Melbourne, VIC.

Competing interests:

No relevant disclosures.

  • 1. Trinh TT, Chan PA, Edwards O, et al. Peripheral venous catheter-related Staphylococcus aureus bacteremia. Infect Control Hosp Epidemiol 2011; 32: 579-583.
  • 2. Collignon PJ, Dreimanis DE, Beckingham WD, et al. Intravascular catheter bloodstream infections: an effective and sustained hospital-wide prevention program over 8 years. Med J Aust 2007; 187: 551-554. <MJA full text>
  • 3. Turnidge JD, Kotsanas D, Munckhof W, et al; Australia New Zealand Cooperative on Outcomes in Staphylococcal sepsis. Staphylococcus aureus bacteraemia: a major cause of mortality in Australia and New Zealand. Med J Aust 2009; 191: 368-373. <MJA full text>
  • 4. Maki DG, Kluger DM, Crnich CJ. The risk of bloodstream infection in adults with different intravascular devices: a systematic review of 200 published prospective studies. Mayo Clin Proc 2006; 81: 1159-1171.
  • 5. Pujol M, Hornero A, Saballs M, et al. Clinical epidemiology and outcomes of peripheral venous catheter-related bloodstream infections at a university-affiliated hospital. J Hosp Infect 2007; 67: 22-29.
  • 6. Maki DG. Improving the safety of peripheral intravenous catheters. BMJ 2008; 337: a630.
  • 7. Pearson M. Guidelines for prevention of intravascular device-related infections. Hospital Infection Control Practices Advisory Committee. Infect Control Hosp Epidemiol 1996; 17: 438-473.
  • 8. O’Grady NP, Alexander M, Burns LA, et al; Healthcare Infection Control Practices Advisory Committee. Guidelines for the prevention of intravascular catheter-related infections. Clin Infect Dis 2011; 52: e162-e193.
  • 9. Bregenzer T, Conen D, Sakmann P, Widmer AF. Is routine replacement of peripheral intravenous catheters necessary? Arch Intern Med 1998; 158: 151-156.
  • 10. Rickard CM, Webster J, Wallis MC, et al. Routine versus clinically indicated replacement of peripheral intravenous catheters: a randomised controlled equivalence trial. Lancet 2012; 380: 1066-1074.


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