Central Line-Associated Bloodstream Infections in Non-ICU Inpatient Wards: A 2-Year Analysis

Rhee, Yoona; Heung, Michael; Chen, Benrong; Chenoweth, Carol E.

doi:10.1017/ice.2014.86

Cited by 24 publications

(30 citation statements)

References 30 publications

(52 reference statements)

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“…In the United States reported CLABSI rates in non-ICUs have varied, ranging from 0.35 infections per 1,000 central-line days to 5.2 infections per 1,000 catheter-days in major teaching hospitals. 19 20 The CLABSI rate in our general wards was 0.81 infections per 1,000 catheter day, which is comparable to the rate in the 2013 device-associated module report of the NHSN. 21 We found 2.71 infections per 1,000 catheter-days in ICUs, and this rate and that reported by KONIS (2.33 infections per 1,000 catheter-days in 2013) are 2-fold higher than the rate reported by the NHSN; the difference may be related to the fact that the interventions for preventing CLABSIs in Korea are less comprehensive than in the United States.…”

Section: Discussionsupporting

confidence: 65%

Two-Year Hospital-Wide Surveillance of Central Line-Associated Bloodstream Infections in a Korean Hospital

et al. 2018

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BackgroundSurveillance and interventions of central line-associated bloodstream infections (CLABSIs) had mainly been targeted in intensive care units (ICUs). Central lines are increasingly used outside ICUs. Therefore, we performed a hospital-wide survey of CLABSIs to evaluate the current status and develop strategies to reduce CLBASI rates.MethodsAll hospitalized patients with central venous catheters (CVCs) were screened for CLABSIs from January 2014 through December 2015 at a 1,328 bed tertiary care teaching hospital in Korea using an electronic data-collecting system. Clinical information including type of CVC was collected. CLABSI rates were calculated using the definitions of the National Health and Safety Network after excluding mucosal barrier injury laboratory-confirmed bloodstream infection (BSI).ResultsA total of 154 CLABSIs were identified, of which 72 (46.8%) occurred in general wards and 82 (53.2%) in ICUs (0.81 and 2.71 per 1,000 catheter days), respectively. Non-tunneled CVCs were most common (68.6%) among 70 CLABSI events diagnosed within one week of their maintenance. On the other hand, tunneled CVCs and peripherally inserted central catheters (PICCs) were more common (60.5%) among 114 CLABSI events diagnosed more than a week after maintenance. Whereas the majority (72.2%) of CLABSIs in ICUs were associated with non-tunneled CVCs, tunneled CVCs (38.9%) and PICCs (36.8%) were more common in general wards.ConclusionCLABSIs are less common in general wards than in ICUs, but they are more often associated with long-term indwelling catheters. Therefore, interventions to prevent CLABSIs should be tailored according to the type of ward and type of catheter.

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Section: Discussionsupporting

confidence: 65%

Two-Year Hospital-Wide Surveillance of Central Line-Associated Bloodstream Infections in a Korean Hospital

et al. 2018

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“…Bloodstream infections (BSI) are quite common in patients with hemato-oncologic diseases as they are often severely immunocompromised due to the underlying disease, to antineoplastic therapy, and/or to hematopoietic stem cell transplantation (HSCT) [1][2][3]. Nosocomial BSIs are often associated with the usage of some kind of invasive device entering the venous blood system such as central vascular catheters (CVC) and are then called central line-associated bloodstream infection (CLABSI) [4].…”

Section: Introductionmentioning

confidence: 99%

Incidence, risk factors and healthcare costs of central line-associated nosocomial bloodstream infections in hematologic and oncologic patients

et al. 2020

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Non-implanted central vascular catheters (CVC) are frequently required for therapy in hospitalized patients with hematological malignancies or solid tumors. However, CVCs may represent a source for bloodstream infections (central line-associated bloodstream infections, CLABSI) and, thus, may increase morbidity and mortality of these patients. A retrospective cohort study over 3 years was performed. Risk factors were determined and evaluated by a multivariable logistic regression analysis. Healthcare costs of CLABSI were analyzed in a matched case-control study. In total 610 patients got included with a CLABSI incidence of 10.6 cases per 1,000 CVC days. The use of more than one CVC per case, CVC insertion for conditioning for stem cell transplantation, acute myeloid leukemia, leukocytopenia (� 1000/ μL), carbapenem therapy and pulmonary diseases were independent risk factors for CLABSI. Hospital costs directly attributed to the onset of CLABSI were 8,810 € per case. CLABSI had a significant impact on the overall healthcare costs. Knowledge about risk factors and infection control measures for CLABSI prevention is crucial for best clinical practice.

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“…The epidemiology of CLABSI has occasionally been evaluated on a national scale; however, studies focused for the most part on the intensive care unit (ICU) setting 2 3. In contrast, very few studies investigated CLABSI outside the ICU 4–7. Of note, the term CLABSI is used for surveillance purposes (where the definition neither requires quantitative criteria nor a microbiological diagnosis of the removed catheter tip), whereas the source of infection in CRBSI is based on a positive culture of the catheter tip.…”

Section: Introductionmentioning

confidence: 99%

Catheter-related infections: does the spectrum of microbial causes change over time? A nationwide surveillance study

et al. 2018

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ObjectivesTo estimate the incidence and epidemiology of catheter-related bloodstream infections (CRBSIs) on a national scale by using prospective epidemiological data from the Swiss Antibiotic Resistance Surveillance System (ANRESIS).DesignObservational study.SettingNational surveillance from 2008 to 2015 of acute hospitals in Switzerland.ParticipantsWe included acute Swiss hospitals that sent blood cultures and catheter tip culture results on a regular basis during the entire study period to the ANRESIS database.Outcome measureA catheter-related bloodstream infection (termed ‘modified CRBSI’, mCRBSI) was defined as isolating the same microorganism with identical antibiogram from ≥1 blood cultures (performed ±7 days around the catheter removal) as the one recovered from the catheter tip. Incidence rates of mCRBSI were calculated per 1000 admissions.ResultsFrom 2008 to 2015, the mCRBSI incidence rate decreased from 0.83 to 0.58 episodes/1000 admissions (−6% per year, p<0.001). Coagulase-negative staphylococci, Staphylococcus aureus and fungi all exhibited decreasing trends, while rates of enterococci and Gram-negative bacteria remained stable.ConclusionsThe overall incidence of mCRBSI in Switzerland is decreasing; however, the incidence of mCRBSI due to Enterococci and Gram-negative micro-organisms did not change over time. These pathogens may grow in importance in catheter-related infections, which would have clinical implications for the choice of empirical treatment.

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Central Line-Associated Bloodstream Infections in Non-ICU Inpatient Wards: A 2-Year Analysis

Abstract: In patients with CLABSIs outside of the ICU, only 10.6% received dialysis prior to infection. However, underlying hematologic malignancy, neutropenia, and PICC lines were highly prevalent in this population.

Cited by 24 publications

References 30 publications

Two-Year Hospital-Wide Surveillance of Central Line-Associated Bloodstream Infections in a Korean Hospital

Two-Year Hospital-Wide Surveillance of Central Line-Associated Bloodstream Infections in a Korean Hospital

Incidence, risk factors and healthcare costs of central line-associated nosocomial bloodstream infections in hematologic and oncologic patients

Catheter-related infections: does the spectrum of microbial causes change over time? A nationwide surveillance study

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