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S. M. Baxi, E. K. Shuman, C. A. Scipione, B. Chen, A. Sharma et al., Resumé : Introduction : Les cathéters centraux à insertion périphérique (Peripherally inserted central catheters [PICC-line]), sont des dispositifs insérés par l'intermédiaire d'un accès veineux périphérique. Dans notre institution, cette technologie a été rapidement adoptée par les cliniciens. Les bactériémies sur cathéters restent une problématique de santé publique importante en France. La mortalité attribuable aux bactériémies sur PICC-line reste encore mal évaluée en France et dans la littérature en générale. Dans notre étude nous rapportons un inventaire exhaustif, sur une période de 7 ans sur l'ensemble des structures de notre institution des bactériémies sur PICC-line et de leur mortalité à 30 jours, Matériel et méthodes : Rétrospectivement de Janvier 2010 à Décembre 2016 nous avons croisé les registres de poses de PICC-lines sur l'ensemble de l'Assistance-Publique Hôpitaux de Marseille (AP-HM) avec les registres des hémocultures positives, vol.34, pp.785-92, 2013.

. Dans-le-même-séjour-hospitalier,-d'une-bactériémie-et/ou-d'un and . Décès, On a recensé 258 cas de bactériémies sur PICC-line sur cette même période soit une prévalence de 2.27 %. Les services d'hématologie : 20/324 (6.17%), d''oncologie : 55/1375 (4%), et d'hépato-gastro-entérologie : 42/1142 (3.66%) présentaient les plus fortes prévalences de bactériémies par poses de PICC-line. L'analyse de corrélation lorsqu'elle était ajustée par pose et par année montrait que le profil du service expliquait 72 % de la variabilité du taux de bactériémie avec un p=0.023. Les bactériémies étaient précoces avec 75 % des bactériémies survenant dans les 21 premiers jours suivant la pose. Le nombre de décès parmi les patients bactériémiques étaient de 57/11 334 poses de PICC-line retenues, soit un taux de 0.50% à 30 jours. La mortalité à 30 jours des patients porteurs de PICC-line était de 1369/11334 soit 12.07%, la mortalité des patients atteint de bactériémies sur PICC-line étant de 57/258 soit 22.09 %, la mortalité des patients sans bactériémie étant de 1311/11076 soit 11, Résultat : 11334 PICC-lines ont été inclus sur une période de 7 ans et suivi pour la survenue

, Conclusion : Les patients bénéficiant de la pose de PICC-lines sont des patients fragiles avec d'importantes comorbidités pour lesquels les épisodes de bactériémies représentent une surmortalité importante. La Pose d'un PICC-line doit rester une solution de dernier recours après évaluation attentive du rapport bénéfices risques par un médecin sénior

, Results: 11334 PICC-lines during hospital stay were included over a period of 7 years. There were 258 cases of bacteremia on PICC-line over this same period, a prevalence of 2.27%. Hematology services: 20/324 (6.17%), oncology services: 55/1375 (4%), and hepato-gastroenterology services: 42/1142 (3.66%) had the highest prevalence of bacteremia PICC-line. The correlation analysis, when adjusted by exposure and year, shows that the service profile explains 72% of the variability in the rate of bacteremia with a p = 0.023. Bacteremia was early with 75% of bacteremia occurring within 21 days of insertion. The number of deaths among bacteremic patients was 57/11 334 retained pic-line poses, a rate of 0.50% at 30 days. The overall 30-day mortality of patients with PICC-line with and without bacteremia was 1369/11334 or 12.07%. Still at 30 days the mortality of patients with bacteremia on PICCline was 57/258 or 22.09% of cases, Mots-clefs : PICC-line, bactériémies, cathéters centraux à insertion périphérique, mortalité Abstract : Introduction: Peripherally inserted central catheters (PICC-line) are devices inserted through peripheral venous access. In our institution, this technology has been rapidly adopted by clinicians in their practices. Bacteremia on catheters remains an important public health issue in France. But the mortality attributable to bacteremia on PICC-line remains poorly evaluated in France and in the literature in general, 2010.