Three-year prospective, observational study of central line–associated bloodstream infections in a 600-bed Japanese acute care hospital

Background Central line–associated bloodstream infection (CLABSI) is an important concern associated with central venous catheter (CVC) use. The objective of this study was to determine the influences of CVC access sites, CVC types, and presumed causative microorganisms on CLABSI occurrence in an ac...

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Published in:American journal of infection control 2015-05, Vol.43 (5), p.494-498
Main Authors: Matsui, Yasuko, RN, Shimatani, Michitsugu, MD, CIC, Kuzuhara, Kenta, RN, Miyazaki, Yoshiko, RN, Horiuchi, Tomoko, MT, Tajima, Yasuhisa, MD, CIC, Yano, Kunio, MD, PhD, Nagata, Toshi, DDS, PhD
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Aged, 80 and over
Bacteria - classification
Bacteria - isolation & purification
Catheter-Related Infections - epidemiology
Catheterization, Central Venous - adverse effects
Catheters
Central line–associated bloodstream infection
Central venous catheters
Female
Fungi - classification
Fungi - isolation & purification
Hospitals
Humans
Infection Control
Infectious Disease
Infectious diseases
Japan
Male
Microorganisms
Middle Aged
Prospective Studies
Sepsis - epidemiology
Surveillance
Young Adult
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Summary:Background Central line–associated bloodstream infection (CLABSI) is an important concern associated with central venous catheter (CVC) use. The objective of this study was to determine the influences of CVC access sites, CVC types, and presumed causative microorganisms on CLABSI occurrence in an acute care hospital. Methods We conducted a prospective, observational study of CLABSI occurrence for 3 consecutive years in a 600-bed Japanese acute care hospital. Data collected included patient characteristics, CVC access sites, CVC types, and microorganisms isolated by blood culture. Results For 1,650 CVCs used for 1,237 patients, 39 cases of infection were identified. Most infections had occurred within 1 month of CVC insertion. Maximal sterile barrier precautions had been used for most cases (97.3%). The average CLABSI occurrence days with internal jugular vein access were shorter than those with subclavian vein access and femoral vein access. CLABSI rates were 1.1 and 0.7 for single- and multilumen CVCs, respectively. CLABSI occurrence tended to be shorter when gram-positive cocci were isolated and tended to be longer when fungi ( Candida spp) were isolated. Conclusion Most CLABSI cases had occurred within 1 month of CVC insertion. Longer CVC duration increased chance of fungal infection.
ISSN:0196-6553
1527-3296
DOI:10.1016/j.ajic.2015.01.011