Early screening of central line-associated bloodstream infections
Abstract:
Purpose: Central line-associated bloodstream infections (CLABSI) are a significant cause of morbidity in critically ill patients. Early detection remains a challenge, as conventional diagnostic markers often fail to capture subtle changes. This study aimed to evaluate the predictive value of inflammatory indices, Aggregate Index of Systemic Inflammation (AISI), Systemic Inflammatory Index (SII) and Systemic Inflammatory Response Index (SIRI), within 2 calendar days of central line insertion.
Methods: We conducted a retrospective analysis of patients who underwent central line insertion. Indices were calculated with the parameters collected within 2 calendar days post-insertion. Logistic regression analysis was used to assess the predictive performance.
Results: Among 234 patients who met the inclusion criteria, 39 were confirmed CLABSI cases. We found all three indices significantly elevated in the CLABSI-positive group and logistic regression confirmed each index as an independent predictor of CLABSI. AISI demonstrated the strongest overall performance, with an optimal cutoff of 3257.4 yielding the highest area under the ROC curve (AUROC = 0.75) and a sensitivity of 87.2%. These indices may serve as the effective early screening marker for CLABSI in this cohort.
Conclusion: AISI, SII and SIRI offer promising, accessible and low-cost early warning tools for CLABSI prediction with AISI emerging as the most reliable marker within 2 calendar days of central line insertion, enabling timely decisions.
Reference:
Anand G, Lahariya R, Sarfraz A, Tiewsoh JBA. Early screening of central line-associated bloodstream infections: A novel comparative analysis of AISI, SII, and SIRI as predictive biomarkers. Am J Infect Control. 2025 Aug 28:S0196-6553(25)00557-7. doi: 10.1016/j.ajic.2025.08.020. Epub ahead of print. PMID: 40885261.