Evaluation of risk factors for central venous line-associated bloodstream infections (CLABSIs) and the benefits of central line bundle application in reducing CLABSIs

Abstract

Purpose: We aimed to identify the risk factors for central line-associated bloodstream infections (CLABSIs) and the efficacy of bundle application to prevent CLABSIs. Materials and methods: This study was performed in the anesthesia-intensive care unit (AICU) of a tertiary hospital. A structured survey form including patients’ characteristics and a central line bundle checklist was used for following of patients. Adult patients who had undergone recent central venous catheter (CVC) insertion at the AICU, those who had been transferred to ICU with the previous catheter insertion in other departments and who had received a diagnosis of CLABSI fourty-eight hours after remaining in the ICU were included in the study. The data obtained were evaluated with respect to the risk factors for CLABSIs. Result: The current study included 156 patients with the mean age 67.97±17.20 years (median 71.00 years), 66 were women (42.3%). Fourty-seven patients developed CLABSIs. Evaluating the results of univariate analysis, the rate of infection was lowest when catheters were inserted with the aim hemodialysis (p<0.01). The subclavian vein (p<0.01) and three-lumen catheters (p<0.01), receiving CVCs under emergency conditions (p=0.04), having been intubated (p=0.01), undergoing surgery (p=0.04) and receiving antibiotics before catheterization (p<0.01), receiving blood products through CVCs (p=0.01), repeat catheter insertions (p<0.01) were found to be associated with the development of CLABSI. Conclusion: In summary, multivariate analyses showed that repeat catheter insertions (p<0.01) and prolonged ICU stay (p<0.01) could raise the risk of CLABSIs. However, the risk of infection was lower (p<0.01) in patients with bundle application. © 2023, Pamukkale University. All rights reserved.