Abstract:
Background: Central line-associated bloodstream infections (CLABSIs) are among the most serious healthcare-associated infections in intensive care units (ICUs), contributing to increased morbidity, mortality, and healthcare burden. However, evidence regarding the epidemiology and outcomes of CLABSI in Saudi Arabian ICUs remains limited. This systematic review and meta-analysis aimed to evaluate the incidence, microbiology, and clinical outcomes of CLABSI among ICU patients in Saudi Arabia.
Methods: A systematic review and meta-analysis were conducted in accordance with the PRISMA guidelines. PubMed, Medline, Embase, and Web of Science were searched for studies published between January 2015 and November 2025. Studies conducted in Saudi Arabian ICUs reporting CLABSI incidence, microbiology, or clinical outcomes were included. Pooled incidence rates were estimated using random-effects meta-analysis. The review protocol was prospectively registered in PROSPERO (CRD420261337969).
Results: Of 2,788 identified records, 11 studies were included in the systematic review and 7 in the meta-analysis. Included studies primarily consisted of retrospective observational, surveillance, and cohort studies conducted across different ICU settings in Saudi Arabia. The pooled CLABSI incidence was 3.05 per 1,000 central line-days (95% CI: 1.85-4.26; I 2 = 96%). Subgroup analyses demonstrated variability according to ICU type, geographic region, and study design. The highest pooled incidence was observed in mixed ICU settings at 3.41 per 1,000 central line-days (95% CI: 1.12-5.69), while individual study estimates ranged from 0.64 to 4.61 per 1,000 central line-days. Studies excluded from the meta-analysis reported CLABSI proportions ranging from 15 to 28.3% of healthcare-associated or ICU-acquired infections. Klebsiella pneumoniae and Acinetobacter baumannii were the predominant pathogens, with several studies reporting multidrug-resistant isolates. CLABSI was associated with increased mortality, prolonged hospitalization, and greater healthcare burden. High heterogeneity and variability in surveillance methods across studies should be considered when interpreting the pooled estimates.
Conclusion: CLABSI remains a significant healthcare-associated infection among ICU patients in Saudi Arabia and is associated with considerable clinical burden. Variability in incidence across ICU settings highlights the importance of strengthening infection prevention strategies and surveillance systems. Further multicenter studies are needed to improve understanding of risk factors, microbiological patterns, and preventive interventions.
Reference:Aldali JA, Alshehr AA, Abdelhamid MA, Alghamdi LG, Alhuwaymani HM, Alharbi LS, Alazwari DA, Alkahtani LS, Khawagi WY. Prevalence and outcomes of central line-associated bloodstream infections in intensive care units in Saudi Arabia: a systematic review and meta-analysis. Front Microbiol. 2026 Jun 11;17:1854248. doi: 10.3389/fmicb.2026.1854248. PMID: 42369535; PMCID: PMC13294151.