Resource-related factors associated with CLABSI
Abstract:
Background: Central line-associated bloodstream infections (CLABSIs) in lower-middle-income countries (LMICs) are a major cause of morbidity and mortality, particularly in patients admitted to intensive care units (ICUs). Despite the scale of this problem, few studies have explored healthcare provider and organizational factors contributing to CLABSIs in LMIC ICUs, and comprehensive literature syntheses remain scarce.
Objectives: To synthesize the published literature on HCP-related, system-related, and resource-related factors associated with CLABSIs in ICUs of LMICs.
Methods: A scoping review was conducted using the JBI methodology. Four electronic databases (MEDLINE, EMBASE, CINAHL, and SCOPUS) were searched from 2011 to 2024 using predefined eligibility criteria based on the PCC framework.
Results: Of 897 articles identified, 30 met the inclusion criteria. Studies were predominantly from the Middle East and North Africa (50%, n=15) and South Asia (43%, n=13), with most using quantitative designs (93%, n=28). Three categories of factors associated with CLABSIs were identified: (1) HCP-related factors, including non-compliance with infection prevention practices, knowledge and training deficits, and technical skill gaps; (2) system-related factors, including weak governance, inadequate policy implementation, poor safety culture, and limited learning opportunities; and (3) resource-related factors, including staffing shortages, high workload, equipment and supply constraints, and financial limitations.
Conclusion: This review identifies a critical gap in the literature: few studies examine CLABSI prevention from the perspective of healthcare providers in LMIC ICUs. Addressing the interconnected HCP, system, and resource-related barriers identified in this review is essential for developing effective, context-appropriate infection prevention strategies.
Reference:
Essani RR, Mehrali S, Mahmood SF, Virani NK, Papathanasoglou E. Identifying health care provider, system, and resource-related factors associated with CLABSIs in ICUs of LMICs: A Scoping Review. Am J Infect Control. 2026 Jun 30:S0196-6553(26)00560-2. doi: 10.1016/j.ajic.2026.06.019. Epub ahead of print. PMID: 42379273.