Local infection signs at the catheter-insertion site: a large prospective multicentric cohort study

@article{buetti2026local,
  title = {{Local infection signs at the catheter-insertion site: a large prospective multicentric cohort study}},
  author = {Niccolò Buetti and Stéphane Ruckly and Aude Nguyen and Jean-Ralph Zahar and Nathalie van der Mee-Marquet and Hervé Rosay and Alexandra Byczko and Guillaume Rigault and Cédric Bruel and Hakim Slimani and Morane Savelli and Muriel Lucas and Sandra Bourdon and Anne-Laure Guinet and Marwa Koumaiha and Chloé Arnould and Jean-François Timsit and . Deepcath Study Group and Etienne Allard and Katty Bardouil and Joël Beaugendre and Adeline Bellet and Laure Blondeau and Yves Boivin and Marion Bonete and Sandra Bourdon and Zoulikha Bouzit and Julia Brochard Libois and Manon Conin and Isabelle Crousaz and Anne Debonne and Peggy Delavault and Frederique Diaw and Kevin Donner and Marie Dubert and Nicolas Dumortier and Florence Espinasse and Pierre Edouard Floch and Marie-Christine Gadras and Louis-Marie Galerneau and Béatrice Gegoux and Carine Ginestet and Benoît Giroud and Elodie Gourgues and Sylvie Joron and Laurie Lamouroux and Vincent Langlois and François Laterza and Bruno Le Falher and Bruno Le Falher and Linda Le Mauguen and Margaux Lechalupé and Liana Lemoine and Sarah Lo-Monaco and Amélie Mulard and Nathan Peiffer-Smadja and Anne Perez Limosin and Camille Reinprecht and Anne Laure Ricci and Valérie Romain},
  journal = {Clinical Microbiology and Infection},
  year = {2026},
  month = sep,
  doi = {10.1016/j.cmi.2026.06.008},
  url = {https://hal.inrae.fr/hal-05763173v1},
  note = {CC BY 4.0},
}

TY  - JOUR
TI  - Local infection signs at the catheter-insertion site: a large prospective multicentric cohort study
AU  - Niccolò Buetti
AU  - Stéphane Ruckly
AU  - Aude Nguyen
AU  - Jean-Ralph Zahar
AU  - Nathalie van der Mee-Marquet
AU  - Hervé Rosay
AU  - Alexandra Byczko
AU  - Guillaume Rigault
AU  - Cédric Bruel
AU  - Hakim Slimani
AU  - Morane Savelli
AU  - Muriel Lucas
AU  - Sandra Bourdon
AU  - Anne-Laure Guinet
AU  - Marwa Koumaiha
AU  - Chloé Arnould
AU  - Jean-François Timsit
AU  - . Deepcath Study Group
AU  - Etienne Allard
AU  - Katty Bardouil
AU  - Joël Beaugendre
AU  - Adeline Bellet
AU  - Laure Blondeau
AU  - Yves Boivin
AU  - Marion Bonete
AU  - Sandra Bourdon
AU  - Zoulikha Bouzit
AU  - Julia Brochard Libois
AU  - Manon Conin
AU  - Isabelle Crousaz
AU  - Anne Debonne
AU  - Peggy Delavault
AU  - Frederique Diaw
AU  - Kevin Donner
AU  - Marie Dubert
AU  - Nicolas Dumortier
AU  - Florence Espinasse
AU  - Pierre Edouard Floch
AU  - Marie-Christine Gadras
AU  - Louis-Marie Galerneau
AU  - Béatrice Gegoux
AU  - Carine Ginestet
AU  - Benoît Giroud
AU  - Elodie Gourgues
AU  - Sylvie Joron
AU  - Laurie Lamouroux
AU  - Vincent Langlois
AU  - François Laterza
AU  - Bruno Le Falher
AU  - Bruno Le Falher
AU  - Linda Le Mauguen
AU  - Margaux Lechalupé
AU  - Liana Lemoine
AU  - Sarah Lo-Monaco
AU  - Amélie Mulard
AU  - Nathan Peiffer-Smadja
AU  - Anne Perez Limosin
AU  - Camille Reinprecht
AU  - Anne Laure Ricci
AU  - Valérie Romain
PY  - 2026
DA  - 2026/09/24
JO  - Clinical Microbiology and Infection
DO  - 10.1016/j.cmi.2026.06.008
UR  - https://hal.inrae.fr/hal-05763173v1
AB  - Objectives: To describe the epidemiology of local signs at intravascular catheter-insertion sites across catheter types and care settings, to compare the identification of redness between local investigators and experts, and to evaluate the association between redness and blood culture positivity in patients with suspected infection. Methods: DeepCath was a prospective multicentre cohort study conducted between September 2022 and December 2023 in France and Switzerland. Adult patients with short-term central venous catheters, arterial catheters, peripheral venous catheters, peripherally inserted central catheters (PICCs), or midlines were included. Local investigators captured one photograph per insertion site and recorded local signs. Four experts independently reassessed all images, serving as the reference standard. Agreement between local investigators and experts on redness was evaluated using Cohen's kappa. Among patients with suspected infection, the association between redness and blood culture results was evaluated. Results: Among 5164 collected images, 2670 eligible catheters (one image per catheter) were analysed: 1447 peripheral venous catheters (54.2%), 608 central venous catheters (22.8%), 296 arterial catheters (11.1%), and 319 PICCs/midlines (11.9%). Local investigators reported signs of local infection in 257 of 2670 catheters (9.6%), mainly redness (218 of 2670, 8.2%). Experts identified local infection signs in 376 of 2670 catheters (14.1%), including redness in 364 of 2670 (13.6%). Redness prevalence varied by catheter type and was highest for PICCs/midlines (82 of 319, 25.7% by expert assessment). Overall agreement for redness was fair (Cohen's kappa of 0.40, 95% CI 0.35-0.46) and was observed in 2358 of 2670 images (88.3%). Among 732 patients with suspected infection who underwent blood cultures diagnostic, redness was more frequent in those with positive cultures (23 of 71, 32.4%) than in those with negative (15 of 225, 6.7%) or pending cultures (40 of 436, 9.2%; p < 0.0001). Conclusions: Local signs at catheter-insertion sites are frequent and differ across catheter type. Redness is underrecognised in routine clinical assessment compared with expert review, supporting the need for standardized, potentially artificial intelligence-assisted approaches in daily practice.
SN  - 1198-743X
SN  - 1469-0691
ER  -