Peripheral intravenous catheters: infection risks

Peripheral intravenous catheters (PIVCs) (also referred to as peripheral intravenous cannulae) are the most common intravenous catheters and are generally used for short-term intravenous access. Although local complications can be common, their risk of causing bacteraemia is relatively low if correctly managed. However, because of the large number of PIVCs used in healthcare settings, they are often the leading cause of healthcare-associated infections, including bacteraemia. Following strict protocols for the insertion, maintenance, access and timely removal of PIVCs can have a dramatic impact on their complication and infection risks (see the National Health and Medical Research Council’s Australian Guidelines for the Prevention and Control of Infection in Healthcare).

Peripherally inserted central catheter (PICC) lines are inserted in the upper limb veins, but the catheter tip is located in the superior vena cava. If PICC lines become infected, this frequently results in bacteraemia and possible right-sided endocarditis. They are generally used for medium-duration therapy (weeks to months) with agents such as parenteral antibiotics (through ambulatory antimicrobial therapy) or chemotherapy. Correspondingly, patients who require a PICC line often have significant comorbidities that place them at higher risk of complications. PICC lines can be easily removed if they become infected.