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Prevention of peripheral intravenous catheter-related bloodstream infections: the need for a new focus

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Careful insertion and maintenance technique on every occasion is important — not routine replacement

Intravascular access device-related bloodstream infections, including Staphylococcus aureus bacteraemias (SABs), cause substantial clinical harm and waste scarce health care resources. And yet, many, if not most, are preventable. We are belatedly realising that to eliminate these complications we must conduct research, implement evidence-based interventions and reduce the clinical practice variation that leads to their occurrence. Public reporting and the financial disincentives associated with apparent poor performance are also pulling us along this path. In this issue of the Journal, Stuart and colleagues provide yet another wake-up call by describing a case series of 137 peripheral intravenous catheter (PIVC)-associated SABs.1 They highlight some important failings in our processes for managing PIVCs that allow devastating complications to occur and which require our urgent attention.

Infections can occur at any time after PIVC insertion, but early infections typically reflect the insertion procedure.2 More than half of the SAB episodes in Stuart et al’s study…