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picc clabsi distinguishing insertion vs maintenance

Our current policy is,  if a break in sterility occurs at insertion clinical signs will appear within 3 days/ 72 hours.  If after 3 days clinical signs manifest it would be a maintenance issue.  Does anyone have evidenced based data to support or challenge this? 

I have never seen this

I have never seen this published in any articles on CRBSI. Here is what is published:

The outer walls of the catheter have more biofilm within the first week of catheter dwell. Skin is considered to be the source of infection when it occurs within the first week of dwell. This could be related to lack of hand hygiene, inadequate skin prep, inadequate securement, or loose, soiled or wet dressing.

After the first week of dwell there is more biofilm on the internal lumen and thus the source of infection is coming from hub manipulation, tubing changes, drawing blood samples, flushing, etc.


Lynn Hadaway, M.Ed., RN, BC, CRNI

Lynn Hadaway Associates, Inc.

126 Main Street, PO Box 10

Milner, GA 30257


Office Phone 770-358-7861

 Our Infectious Disease

 Our Infectious Disease Physicians use the 72 hour time break as well to determine insertion vs use for CRBSI. But, every case is individual based on what else is occurring with the patient.


Lauren Blough, RN, BS, CRNI

Clinical Specialist-Educator

Florida Hospital 

Orlando, Fl

Lauren Blough, RN, BS, CRNI, VA-BC
Clinical Development Manager
Biolife, LLC "Makers of StatSeal"

Gwen Irwin
PICC CLABSI insertion vs. maintenance

We also use the 7 day time period to determine insertion vs. maintenance.

Our infection preventionists support this.  I cannot quote evidence.

Gwen Irwin

Austin, Texas

Interventional ...
PICC clabsa insertion vs maintenance

Our Infection Control Directors use the 72 hour standard. NO evidence based data to support yet however, plans for a study are being looked at.

no time exists

In an acute care CVAD there is no time window I know of that is evidence based.  My speculation is insertion CLA-BSI can occur at any point of the dwell time unless the bacteria is smart enough that is introduced at insertion on day 3 or day 7 to say we cannot be the cause.  There is no magic window.


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