Peripherally Inserted Central Venous Catheter (PICC) Related Bloodstream Infection in Cancer Patients Treated with Chemotherapy Compared with Noncancer Patients: A Propensity-Score-Matched Analysis

SIMPLE SUMMARY: The use of peripherally inserted central catheters (PICCs) or PICC lines has become an established part of daily practice due to their ease of insertion, maintenance, and removal. Their use has increased particularly in cancer patients treated with chemotherapy who are immunocompromised and, therefore, known to have an increased risk of infection. However, the risk of PICC-related infections in this population compared to noncancer patients remains poorly evaluated. We found that the PICC-related bloodstream infection rate was more than twice as high in cancer patients compared to noncancer patients. In addition, we confirmed that dual-lumen PICCs had a higher risk of PICC-related bloodstream infection than single-lumen PICCs. Our results encourage physicians to carefully implement infection-control measures in cancer patients receiving chemotherapy through a PICC and particularly to limit the number of catheter lumens in these patients. ABSTRACT: The use of peripherally inserted central catheters (PICCs) has increased in cancer patients. This study aimed to compare the incidence of PICC-related bloodstream infections (PICCR-BSIs) in cancer patients treated with chemotherapy and in noncancer patients. We performed a secondary analysis from a retrospective, single-center, observational cohort. The PICCR-BSI incidence rates in cancer and noncancer patients were compared after 1:1 propensity-score matching. Then, the factors associated with PICCR-BSI were assessed in a Cox model. Among the 721 PICCs (627 patients) included in the analysis, 240 were placed in cancer patients for chemotherapy and 481 in noncancer patients. After propensity-score matching, the PICCR-BSI incidence rate was 2.6 per 1000 catheter days in cancer patients and 1.0 per 1000 catheter days in noncancer patients (p < 0.05). However, after adjusting for variables resulting in an imbalance between groups after propensity-score matching, only the number of PICC lumens was independently associated with PICCR-BSI (adjusted hazard ratio 1.81, 95% confidence interval: 1.01–3.22; p = 0.04). In conclusion, the incidence rate of PICCR-BSI is higher in cancer patients treated with chemotherapy than in noncancer patients, but our results also highlight the importance of limiting the number of PICC lumens in such patients.