“Our local recommendation is to perform a Doppler ultrasound for every patient with a central-line associated bloodstream infection, even if there are no symptoms of thrombosis, as the duration of antibiotic therapy is extended in case of thrombosis, in association with an anticoagulation treatment,” states Dr. Anne Thiebaut-Bertrand, MD, hematologist.
Dr. Thiebaut-Bertrand’s report “Early PICC-line infection in non-neutropenic patients are mainly due to E. coli suggesting that third-generation cephalosporin may be used as a first-line antibiotic therapy” was published in Infectious Disease Now. 54 (2024) 104842.e. In it, she explained, “Between January 1, 2017, and June 30, 2020, 370 PICCs were inserted among 275 patients with hematological malignancies. Among the 370 PICCs, there were 106 bacteremia (29 %). All in all, 54/106 were confirmed as central-line associated bloodstream infections (51 %). Thirty-three Gram-negative bacteria were identified, and they were involved in 29/54 central-line associated bloodstream infection episodes (54 %).”
Read Dr. Thiebaut-Bertrand’s article for more information.
Dr. Greg Vigna, national sepsis attorney, states, “The author’s comments regarding extending IV antibiotics longer in patients with thrombosis is interesting. When I practiced, I would do the same thing in septic patients with infected lines that had an associated blood clot understanding the longer patients remain on IV antibiotics the greater the risk of systemic toxicity from the drug, C-diff colitis, and other complications that can potentially take a patient down a miserable path.”
Dr. Vigna adds, “In this study, the rate of bacteremia was 29% of all PICC lines, and about half turned out to be an infected line as the source. Every patient who needs a PICC line should have a super hydrophilic tubing or catheter that goes in the vein. This tubing prevents platelets and bacteria from sticking on the tubing reducing the risk of blood clots and sepsis. The patients in this study have cancer. They don’t need line sepsis on top of that diagnosis.”
Dr. Vigna continues, “We are investigating sepsis associated with polyurethane PICC line, sepsis associated with polyurethane dialysis catheters, sepsis associated with medPorts, and sepsis associated central-line infections. Approximately 15-20% of patients with hospital acquired bloodstream infections are caused by central line infections. Each person who develops a line infection and bloodstream infection deserves better. The polyurethane PICC line cash-cow for pharmaceutical companies must be put to pasture. An overwhelming majority of PICC lines, and other central lines on the market are defective because they use the old, obsolete, polyurethane technology for the tubing that is in the bloodstream that don’t have designs that reduce the risk of infections.”
Dr. Vigna concludes, “There are safer alternative designs that substantially reduces the risk of infection and blood clots.”
What is sepsis? Multiple organ damage from inflammation as a result of infection that may result in organ damage to brain, kidney, heart, liver, and lung.
What is septic shock? A life-threatening condition that caused dangerously low blood pressure because of infection that may result in amputations of fingers and toes, brain damage, kidney failure, ventilator dependence, oxygen dependence, and nerve damage.
Dr. Vigna is a California and Washington DC lawyer who represents those with serious injuries cause by defective medical devices including PICC line, midlines, central lines, dialysis catheters, and MedPorts. He represents the injured with the Ben Martin Law Group, a national pharmaceutical injury law firm in Dallas, Texas. The attorneys are product liability and medical malpractice attorneys, and they represent the most injured across the country.
