Steel needles used for intravenous therapy. Morbidity in patients with hematologic malignancy

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Abstract
The morbidity associated with steel needles used for i.v. therapy in adults with hematologic malignancy was studied. Of 148 needles, 52 (36.1%) produced local inflammation, increasing with placements exceeding 24 h, use of dextrose-containing infusate or i.v. antibiotics, granulocytopenia and local infection. Eight needles (5.4%) caused local infection and 3 (2.1%) caused septicemia. Of 9 bacteremias occurring in the 43 study patients, none of the 5 caused by Gram-negative bacilli, but 3 of the 4 caused by staphylococci, originated from steel needles. Five of 8 local infections and all septicemias occurred with placements exceeding 72 h (P = 0.016); each patient with septicemia was granulocytopenic. I.v. steel needles are a major source of morbidity in patients with granulocytopenia or who are otherwise immunologically compromised. The insertion site should be routinely rotated at least every 3 days. Nosocomial staphylococcal bacteremia in granulocytopenic patients is likely to be due to an i.v. needle or similar device used for vascular access.

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