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Michigan PICC-CLABSI (MPC) Score of Herc et al for Peripherally-Inserted Central Catheter (PICC) Associated Blood Stream Infection

Description

Herc et al developed the MPC score to predict central line-associated bloodstream infection (CLABSI) associated with a peripherally-inserted central catheter (PICC). This can help to identify a patient who may benefit from more aggressive management. The authors are from Michigan Medicine and Veterans Affairs Ann Arbor Health System in Ann Arbor Medicine.


Patient selection: PICC line

 

Outcome: CLABSI

 

Parameters:

(1) past or present history of hematologic cancer

(2) history of CLABSI within the 3 months prior to PICC line insertion

(3) number of lumens to the PICC line

(4) active solid cancer with ongoing chemotherapy

(5) delivery of total parenteral nutrition (TPN) through the PICC line

(6) presence of another central line at the time of PICC line placement

 

Parameter

Finding

Points

history of hematologic cancer

no

0

 

yes

3

history of CLABSI

no

0

 

yes

2

number of lumens

1

0

 

>= 2

2

solid cancer

no

0

 

yes

1

delivery of TPN

no

0

 

yes

1

another central line

absent

0

 

present

1

 

total score =

= SUM(points for all 6 parameters)

 

Interpretation:

• minimum score: 0

• maximum score: 10

• The higher the score the greater the risk of a central line infection.

 

Score

CLABSI by Day 28

0

0.9%

1

1.4%

2

2.3%

3

3.7%

4

5.9%

5

9.5%

6

15%

 

Performance:

• The area under the ROC curve varies with the length of time that the PICC has been in place (0.67 for 6 days and 0.77 for 40 days).


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