CLABSI rates in Greece
Abstract:
Background: Central line-associated bloodstream infections (CLABSI) are serious healthcare-associated infections with substantial morbidity and hospital costs.
Aim: To investigate the association between the incidence of CLABSI, the implementation of specific infection control measures, and the incidence of multidrug-resistant (MDR) bacteraemias in a tertiary-care hospital in Greece from 2013-2018.
Methods: Analysis was applied for the following monthly calculated indices: 1.CLABSI rate, 2.use of hand hygiene disinfectants, 3.isolation rate of patients with MDR bacteria, 4.incidence of bacteraemias [total resistant Gram-negative: carbapenem-resistant (CR) Acinetobacter baumanii, Pseudomonas aeruginosa, Klebsiella pneumoniae and/or Gram-positive: meticillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci].
Findings: Total bacteraemias from CR-Gram-negative pathogens statistically correlated with increased CLABSI rate in total Hospital Departments (IRR: 1.17, 95% CI: 1.05-1.31, p-value: 0.006) and Adults ICU (IRR: 1.37, 95%CI: 1.07-1.75, p-value: 0.013). In Adults ICU, every increase in the incidence of each resistant Gram-negative pathogen significantly correlated with decreased CLABSI rate (CR-A. baumanii: IRR: 0.59, 95%CI: 0.39-0.90, p-value=0.015; CR-K. pneumoniae: IRR: 0.48, 95%CI: 0.25-0.94, p-value=0.031; CR-P. aeruginosa: IRR: 0.54, 95%CI: 0.33-0.89, p-value=0.015). The use of hand disinfectants correlated with decreased CLABSI rate 1-3 months before the application of this intervention, in total Hospital Departments (IRR: 0.80, 95%CI: 0.69-0.93, p-value: 0.005), and for scrub disinfectants the current month in Adults ICU (IRR: 0.34, 95%CI: 0.11-1.03, p-value: 0.057). Isolation of patients with MDR pathogens was not associated with CLABSI incidence.
Conclusion: Hand hygiene was associated with a significant reduction of CLABSI incidence in our hospital. Time-series analysis is an important tool to evaluate infection control interventions.
Reference:
Papanikolopoulou A, Maltezou HC, Gargalianos-Kakolyris P, Michou I, Kalofissoudis Y, Moussas N, Pantazis N, Kotteas E, Syrigos K, Pantos C, Tountas Y, Tsakris A, Kantzanou M. Central line-associated bloodstream infections, multidrug-resistant bacteraemias and infection control interventions: a six-year time-series analysis in a tertiary-care hospital in Greece. J Hosp Infect. 2022 Feb 8:S0195-6701(22)00036-6. doi: 10.1016/j.jhin.2022.01.020. Epub ahead of print. PMID: 35149172.