Comprehensive risk assessment and evaluation of the impact of amino acid preparations on peripheral line-associated bloodstream infection: A single-center retrospective observational study using propensity score matching.

INTRODUCTION

Peripheral line-associated bloodstream infection (PLABSI) is a critical healthcare-associated infection. This study aimed to comprehensively clarify PLABSI risk factors and evaluate the independent impact of amino acid preparations.

METHODS

A retrospective observational study (April 2015-December 2022) included 5553 patients with peripheral intravenous catheters. To adjust for confounding, propensity score matching was performed based on amino acid administration. A doubly robust multivariate logistic regression analysis was conducted on 4664 matched cases (88 with PLABSI).

RESULTS

Pre-matching, Staphylococcus aureus (25.0%) was the most frequent pathogen among 108 PLABSI cases. In the matched cohort, amino acid administration (odds ratio [OR], 2.22; 95% confidence interval [CI], 1.35-3.65), hospital transfer (OR, 1.44; 95% CI, 1.11-1.87), older age (OR, 1.02; 95% CI, 1.00-1.04), and intravenous injection frequency (per 10-time increase: OR, 1.03; 95% CI, 1.02-1.05) were identified as independent risk factors.

DISCUSSION: Frequent catheter manipulation and the nutrient-rich, endothelial-damaging environment caused by amino acid preparations strongly elevate the risk of PLABSI.

CONCLUSIONS

Strict aseptic handling of catheter hubs and continuous daily site monitoring are essential.