What criteria is everyone using to report infected PICC lines?Â
How is everyone reporting? Do you separate inpatient infections from outpatient? Do you separate PICC lines from other central lines?  And what infection rates are you having? Â
Does anyone know what the national average of infections for PICC lines only would be?
Currently we report using INS standard of blood culture and cath tip positive with same organism, however that does not correlate with our Infection Control practitioner, as she uses the CDC criteria.
Using CDC criteria, of positive blood with line present (The surveillance definitions for catheter-associated BSI includes all BSIs that occur in patients with CVCs, when other sites of infection have been excluded.)  likely over estimates the occurance.
The real problem is created when a physician suspects a picc line infection, has blood cultures drawn, but not catheter tip. We have not gone to time to positivity as of yet.
In our Trauma level 1 medium size public hospital, Infection control does the Infection studies/reports using the CDC criteria, which we are aware give a "higher rate" of infection.
They do annual studies of In-Patient PICC infection rate, separated from In-Patient CVAD infection rate. We do not follow our out patient population because it is impossible to track them.
We look to see which nursing wards, which ICU, and what type of patients has an unusual high rate and use the information to target teaching on PICC care and maitnance.
We teach our house staff and nursing staff to send all PICC tips if the reason for PICC removal is "suspected infection".
In 2004 I had a personal conversation with Dr. Maki about In-patient PICC infection rate, he said there were no published studies out there looking specifically at In-patient population but that he thinks the rate SHOULD NOT EXCEED 2.0 per 1000 catheter days for that population.