Central catheter-associated bloodstream infection surveillance
Abstract:
Background: Central line-associated bloodstream infections (CLABSI) are associated with relevant morbidity and mortality. Longitudinal dynamics in CLABSI incidence and the spectrum of causative microorganisms are limited.
Objective: We aimed to describe trends in CLABSI incidence, use of central lines, and causative pathogens.
Methods: We analysed prospectively collected data on CLABSI at a Swiss tertiary care hospital between January 2016 and December 2023. We investigated longitudinal changes of incidence densities, catheter utilization and causative pathogens.
Results: A total of 707 CLABSI were observed, corresponding to an incidence density of 1.69 (95% CI 1.56 – 1.81) CLABSI per 1000 catheter-days. There was no significant trend of CLABSI incidence density per 1000 catheter-days (z=0.86, P=0.391), but an increase of catheter utilization ratio (z=8.88, P<0.001). Coagulase-negative staphylococci (CNS) (n=207, 23.4%) and Enterococcus spp. (n=134, 15.2%; E. faecium n=94, 10.6%; E. faecalis n=37, 4.1%; other Enterococcus spp. n=3, 0.34%) were the most frequent causative pathogens. Over the years, the proportion of Enterococcus spp. (z=3.4, P<0.001), driven by an increase of E. faecium (z=3.2, P=0.001), and yeast (z=2.3, P=0.020) increased, whereas CNS decreased (z=-6.1, P<0.001).
Conclusions: Prospective CLABSI surveillance indicated stable incidence densities per 1000 catheter-days, but there were significant shifts of causative microorganisms over time.
Reference:
Obenhuber T, Pfister M, Reiber C, Dunic M, Falk C, Zingg W, Schreiber PW. Trends in surveillance indicators for central catheter-associated bloodstream infections in a tertiary hospital in Switzerland. J Hosp Infect. 2024 Oct 10:S0195-6701(24)00328-1. doi: 10.1016/j.jhin.2024.09.019. Epub ahead of print. PMID: 39395465.