{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T16:46:29Z","timestamp":1782319589666,"version":"3.54.5"},"reference-count":33,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T00:00:00Z","timestamp":1771286400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Nutr."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Catheter-related bloodstream infection (CRBSI) remains one of the most severe complications in patients receiving home parenteral nutrition. Tunneled central venous catheters (CVCs) and peripherally inserted central catheters (PICCs) are the most commonly used devices for home parenteral nutrition. However, the relative risks of CRBSI from these devices remain controversial. This meta-analysis aimed to compare the incidence of CRBSI between PICCs and tunneled CVCs in patients receiving home parenteral nutrition.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic search of PubMed, Embase, and the Cochrane Library databases was conducted from database inception to 3 June 2025 to identify studies comparing the incidence of CRBSI between PICCs and tunneled CVCs in patients receiving home parenteral nutrition. Pooled risk ratios (RRs) with 95% confidence intervals (CIs) were calculated to assess the relative risk of CRBSI associated with PICCs versus tunneled CVCs using either the fixed-effects model or the random-effects model. The certainty of evidence was assessed using the GRADE approach.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 10 articles, involving 1,139 patients with PICCs or tunneled CVCs, were included in the meta-analysis. The mean CRBSI rate was 0.77 per 1,000 PICC-days and 1.01 per 1,000 tunneled CVC-days. The pooled analysis demonstrated that PICCs were associated with a significantly lower risk of CRBSI compared with tunneled CVCs (RR:0.40, 95%CI:0.33\u20130.49). Subgroup analyses stratified by study design, patient population, and CRBSI definition yielded consistent results, confirming the robustness of the primary findings. According to the GRADE approach, the quality of evidence was very low for the CRBSI rate.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>PICCs were associated with a lower risk of CRBSI than tunneled CVCs in patients receiving home parenteral nutrition. However, the certainty of evidence was very low; therefore, these findings should be interpreted with caution, and further high-quality studies are needed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fnut.2026.1742418","type":"journal-article","created":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T05:17:55Z","timestamp":1771305475000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Comparison of catheter-related bloodstream infection between peripherally inserted central catheters and tunneled central venous catheters in patients receiving home parenteral nutrition: a meta-analysis"],"prefix":"10.3389","volume":"13","author":[{"given":"Yu-Li","family":"Zheng","sequence":"first","affiliation":[{"name":"Department of Oncology, Zhejiang Hospital","place":["Hangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Oncology, Zhejiang Hospital","place":["Hangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shu-Ping","family":"Qi","sequence":"additional","affiliation":[{"name":"Department of Gynecology, Zhejiang Hospital","place":["Hangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of General Practice, Zhejiang Hospital","place":["Hangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pei-Yan","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Gynecology, Zhejiang Hospital","place":["Hangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,2,17]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"2558","DOI":"10.3390\/nu14132558","article-title":"Home parenteral and enteral nutrition","volume":"14","author":"Bering","year":"2022","journal-title":"Nutrients"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1645","DOI":"10.1016\/j.clnu.2020.03.005","article-title":"ESPEN guideline on home parenteral nutrition","volume":"39","author":"Pironi","year":"2020","journal-title":"Clin Nutr"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1002\/jpen.1455","article-title":"American society for parenteral and enteral nutrition guidelines for the selection and care of central venous access devices for adult home parenteral nutrition administration","volume":"43","author":"Kovacevich","year":"2019","journal-title":"JPEN J Parenter Enteral Nutr"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"210","DOI":"10.1002\/ncp.10262","article-title":"Repair of central venous catheters in home parenteral nutrition patients","volume":"34","author":"Salonen","year":"2019","journal-title":"Nutr Clin Pract"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1111\/hdi.70005","article-title":"Practical strategies for prevention of catheter-related bloodstream infections (CRBSI) in United States hemodialysis facilities","volume":"30","author":"Wong","year":"2025","journal-title":"Hemodial Int"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"e43658","DOI":"10.2196\/43658","article-title":"Venous access: national guideline and registry development (VANGUARD): advancing patient-centered venous access care through the development of a national coordinated registry network","volume":"25","author":"Iorga","year":"2023","journal-title":"J Med Internet Res"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"1597","DOI":"10.3390\/microorganisms12081597","article-title":"Epidemiology and clinical insights of catheter-related Candidemia in non-ICU patients with vascular access devices","volume":"12","author":"Scaglione","year":"2024","journal-title":"Microorganisms"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"1208","DOI":"10.1016\/j.ajic.2023.05.002","article-title":"Complications associated with the use of peripherally inserted central catheters and midline catheters in COVID-19 patients: an observational prospective study","volume":"51","author":"Frondizi","year":"2023","journal-title":"Am J Infect Control"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"2100610","DOI":"10.2807\/1560-7917.ES.2022.27.19.2100610","article-title":"Trends in the epidemiology of catheter-related bloodstream infections; 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