Introduction: Midline catheters (MC) are peripheral intra venous access devices placed in brachial or cephalic vein, which tip extends beyond the axillary line without reaching to the vena cava. They have a dwell time of up to 4 weeks. In our medico-surgical center, main indications are prolonged parenteral antibiotic treatments, parenteral nutrition and some chemotherapies. MC are inserted by a dedicated nurse team using ultra sound guidance. We observed a growing demand for this device up to over 300 catheters per year, in our 400-bed hospital, especially because of their ease of insertion and use. The safety of this device is reported to be good, but the literature is relatively scarce and often based on retrospective data.
Objective: The aim of this study is to determine the incidence of bloodstream infection (BSI) related to MC (MC-BSI). Our secondary objectives are to specify risk factors associated with MC related infections, to determine the incidence of MC related venous thrombosis, and to evaluate patient comfort.
Methods: In this prospective single-centre cohort study, we will include consecutive patients eligible for a MC according to the physician in charge. Basically, over 18 years old patients undergoing more than 6 days of intra venous treatment are included. Demographic, insertion (e.g. vein depth, number of punctures…), clinical, biological and bacteriological data are prospectively collected. MC-BSI is defined as a combination of one or more positive peripheral blood cultures sampled immediately before or within 48 hours after catheter removal, a positive catheter-tip culture positive for the same microorganisms or a blood culture differential time-to-positivity of 2 hours or more, and no other infectious focus explaining the positive blood cultures.
Inclusions started on the 15th of January 2018 and are ongoing for one year with an objective of 250 patients.
ClinicalTrials.gov identifier (NCT number): NCT03373630

Risk of midline catheter-related bloodstream infections in medical and surgical patients. A monocentric prospective study