Keywords
Midline
Infective Risk
Ultrasound Guidance
How to Cite
Abstract
Introduction. Patients admitted to infectious diseases units frequently require prolonged intravenous therapy and repeated blood sampling, making reliable peripheral venous access essential. However, conventional peripheral cannulation is often challenging due to poor vein quality and repeated insertions. To enhance vascular access management, nurses were trained to insert peripheral venous access devices such as mini-midline and midline catheters. This study aimed to evaluate the infectious risk associated with these devices, with particular focus on catheter tip pathogen colonization.
Methods and materials. A retrospective observational study was conducted at an Infectious Diseases Clinic of a university hospital in Northeast Italy. Medical records of patients who received a mini-midline or midline catheter inserted by trained nursing staff between January and August 2023 were reviewed. Data were collected for 50 consecutive patients and included indications for catheter removal, occurrence of suspected infection, and results of catheter tip culture examinations when available. Descriptive analysis was performed to assess the incidence of suspected infection and confirmed device colonization.
Results. Among the 50 evaluated catheters, 6 (12.0%) were removed due to suspected infection. Catheter tip cultures were performed in these cases, and only one device showed microbiological growth. The single positive culture identified Staphylococcus epidermidis and was obtained from a mini-midline catheter inserted using the Seldinger technique; notably, this catheter had been removed for reasons unrelated to infection. No confirmed catheter-related infections were documented.
Discussion. These findings suggest that mini-midline and midline catheters are associated with a low risk of infectious complications, particularly device colonization, when inserted by adequately trained nurses. This supports their safe use in patients requiring medium-term venous access in infectious diseases settings. Nevertheless, the retrospective design and limited sample size restrict the generalizability of the results. Larger, prospective studies are warranted to further confirm the safety profile of these devices.
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