Risk of Infection Using Peripherally Inserted Central and Umbilical Catheters in Preterm Neonates

Pediatrics. 2015 Dec;136(6):1073-9. doi: 10.1542/peds.2015-2710. Epub 2015 Nov 16.


Objective: To compare the rates of catheter-associated bloodstream infection (CABSI) in preterm infants born at <30 weeks' gestation who received a peripherally inserted central catheter (PICC) versus an umbilical venous catheter (UVC) immediately after birth as their primary venous access.

Methods: This retrospective matched cohort study examined data from infants born at <30 weeks' gestation and admitted between January 2010 and December 2013 to neonatal units in the Canadian Neonatal Network. Eligible infants who received a PICC on the first day after birth (day 1) were matched with 2 additional groups of infants, those who received a UVC on day 1 and those who received a UVC on day 1 that was then changed for a PICC after 4 days or more. The primary outcome was number of infants with CABSI per 1000 catheter days, which was compared between the 3 groups using multivariable analyses.

Results: Data from 540 eligible infants were reviewed (180 per group). There was no significant difference in infants with CABSI/1000 catheter days between the 3 groups (9.3 vs 7.8 vs 8.2/1000 catheter days, respectively; P > .05) despite lower rates of late onset sepsis in the group of infants who received only a UVC.

Conclusions: There was no significant difference in the incidence of CABSI between very preterm neonates who received a PICC, UVC, or UVC followed by PICC as the primary mode of venous access after birth. A prospective randomized controlled trial is justified to further guide practice regarding primary venous access and reduction of infection.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Canada / epidemiology
  • Catheter-Related Infections / epidemiology*
  • Catheterization, Central Venous / adverse effects*
  • Catheterization, Peripheral / adverse effects*
  • Cohort Studies
  • Female
  • Humans
  • Incidence
  • Infant, Newborn
  • Infant, Premature
  • Intensive Care Units, Neonatal
  • Male
  • Retrospective Studies
  • Risk
  • Sepsis / epidemiology*
  • Sepsis / etiology
  • Umbilical Veins