Aim: To quantify risk of primary bloodstream and local infections associated with peripheral intravenous catheters (PIVCs) in adults, and to assess relationship to dwell time.
Methods: We synthesized data from multiple prospective research studies in Australia (12 studies; 12,942 PIVs) with rigorous prospective collection of dwell times and infection outcomes using National Health and Safety Network (NHSN) 2018 criteria. PIVCs were inserted in a range of clinical departments and by various inserters; ultrasound was not used, and IV insertion teams were rare. Post-insertion care was by bedside nursing staff using routine hospital policies. Infections were blind-adjudicated. Dwell times were calculated from insertion and removal times, and life tables constructed.
Results: PLABSI occurred in 6/12,942 (0.05%) PIVCs or 0.14 per 1000 PIVC days. This included one SAB (0.01%; 0.02/1000 PIVC days). Of these PLABSI cases, 3/12,942 (0.02%; 0.07 per 1000 PIVC days) met the criteria for PRBSI. In addition, there were 3/12, 942 (0.02%) CVS-VASC local infections. PIVCs were in place for <1 to 42 days and primary BSIs occurred on dwell days 2 to 7, with no significant difference in risk by day of dwell (p>0.05).
Conclusion: While infections can occur, and ongoing vigilance is required to prevent them, this prospective, rigorous follow up of PIVCs identified a low rate of associated BSI and local infections under typical Australian hospital conditions. There was no significant increase in BSI risk with dwell time. We caution that all PIVCs should be monitored daily and removed as soon as no longer needed, if there is any complication or suspicion of infection.

The incidence and cumulative risk of primary bloodstream and venous infections in 12,623 peripheral intravenous catheters in Australia