Intensive care unit CLABSI rates
Abstract:
Introduction: Central venous catheters (CVCs) are commonly inserted in critically ill patients. However, their essential use increases the risk of complications, notably central line-associated bloodstream infections (CLABSIs). In recent years, CLABSIs have garnered growing attention due to their significant impact on patient outcomes.
Aims: The aim of this study was to determine the incidence of CLABSIs in the intensive care units (ICUs) of a tertiary care hospital.
Materials and methods: This prospective study was carried out in the Department of Microbiology, KIMS Hospital, Amalapuram, Konaseema district of Andhra Pradesh from January 2024-December 2024 after obtaining Ethics Committee approval. When bacteremia was suspected in patients admitted to the ICUs, blood samples were collected for culture. Central lines (CLs) were inserted under strict aseptic precautions consistent with the standard protocol. Two sets of blood samples for culture were collected over 24 h, one from a peripheral vein and the other from the central venous lines (CVL) from patients in case of new-onset sepsis following central venous catheterization, and processed according to standard microbiological techniques. Blood samples for culture were collected using an ideal venepuncture technique into blood culture bottles following strict aseptic precautions, transported immediately to the laboratory, and then processed by incubating the bottles in Bactec. After the appearance of a flag-positive in positive cultures, it was further processed, and bacterial colonies were identified. The phenotypic identity of pathogens and antimicrobial sensitivity was performed by BD-Phoenix M50 as per Clinical and Laboratory Standard Institute (CLSI) guidelines 2024.
Results: Out of 175 blood samples collected, 49 (28%) blood cultures were positive and showed growth. Of these culture positives, Gram-negative bacilli 28 (57.2%) predominated over Gram-positive cocci 21 (42.8%). Among Gram-negative bacilli, Klebsiella pneumoniae was the most common organism isolated in 13 cases, accounting for 26.5%, followed by Acinetobacter baumanii 6 (12.2%), Escherichia coli 5 (10.2%), and Psudomonas aeuruginosa 4 (8.1%). From Gram-positive cocci, Staphylococcus aureus 10 (20.4%), Coagulase-negative Staphylococcus (CONS) 9 (18.3%), and Streptococcus pneumonia in 2 (4.08%) cases were isolated.
Conclusion: Septicemia and multi-organ failure are often caused by bloodstream infections, particularly in patients undergoing prolonged hospitalization with catheterization. Extended use of intravascular devices increases the risk of catheter-associated infections, contributing significantly to morbidity, mortality, and healthcare costs. This economic and clinical burden can be minimized through the use of catheter lock solutions and the local application of antibiotics, which help prevent microbial colonization and infection. Furthermore, regular surveillance and strict adherence to infection control practices are crucial for reducing infection rates, associated complications, and deaths. Timely culture and sensitivity testing also play a vital role in identifying specific pathogens, enabling targeted antimicrobial therapy and improving patient outcomes.
Reference:
Padmaja N, Purushottam MD, Swaroop PS, Marlapati M. Microbial Study and Antibiogram of Central Line-associated Bloodstream Infections at KIMS Hospital, Konaseema District of Andhra Pradesh. Ann Afr Med. 2026 Mar 19. French, English. doi: 10.4103/aam.aam_455_25. Epub ahead of print. PMID: 41889211.