943 An Analysis of Different Treatment Strategies for Catheterrelated Sepsis in Neonates with Percutaneously Inserted Central Venous Catheter: Removal or Not?

Objectives: To determine if removal of percutaneously inserted central venous catheter (PICC) is compulsory in neonates with catheterrelated sepsis (CRS) and the risk factors of infectious complications if the PICC is retained. Method: A cohort study of neonates who had PICCs and developed CRS between 2001 and 2007 was conducted in our neonatal intensive care unit. CRS was defined as a positive blood-culture confirmed clinical sepsis. Results: 99 cases had early removal of PICC (ERPICC) within 3 days and 135 cases had retained PICC (LR-PICC) for more than 3 days after onset of clinical sepsis. Resolution of clinical sepsis within 2 days was more frequent in the ER-PICC than LRPICC group (80.8% vs. 57.8%, P< 0.001). Although there was no significant difference between these two groups in terms of infectious complications and cases fatalities, the LR-PICC group had significantly higher incidence of recurrence within one month after CRS (P=0.002). Inappropriate initial antibiotic treatment was the only variable independently associated with infectious complications (OR [95% CI]=11.4 [3.34∽39.2], P=0.001). Conclusions: PICCs should be removed in CRS because retention of PICCs for more than three days will delay resolution of clinical sepsis and lead to higher incidence of recurrence within one month.