Insertion site inflammation associated with CLABSI
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Researchers found an association between insertion site inflammation and central line-associated bloodstream infections, according to a recent study.
The researchers said automated surveillance for insertion site infection (ISI) could help prevent these infections.
“Central-line-associated bloodstream infections (CLABSIs) are preventable health care-associated infections. CLABSIs are costly and can make people very sick,” Takaaki Kobayashi, MD, infectious disease specialist at the University of Iowa Hospitals & Clinics, told Healio. “Fortunately, CLABSI rates are decreasing in the United States but that makes it harder to assess progress, as monitoring infrequent events is less reliable month to month. Increases in CLABSI rates may be artificial, and precious efforts may be wasted investigating random variations in this relatively rare event.”
Kobayashi and colleagues retrospectively extracted and assessed insertion site assessment data from electronic health records for all inpatients with central lines from January 2015 to October 2018 at the University of Iowa Hospitals & Clinics. According to the study, researchers then performed a case-control study and a 1:2 match of patients with non-mucosal barrier injury (non-MBI) CLABSI to patients with a central line without CLABSI.
Overall, from January 2015 to October 2018, 2,324,446 central line assessments were performed by nursing staff and 286 CLABSIs were detected. Of those, 194 cases had two matching controls and were included in the study. ISI either at or before CLABSI onset among cases was more frequently documented in patients with CLABSI compared with controls (30.4% vs. 22.4%; OR = 1.51; 95% CI, 1.03-2.23). According to the study, ISI incidence decreased from approximately 80 to approximately 50 ISI days per 1,000 central line days during the study, whereas non-MBI CLABSI rates decreased from approximately 1.5 to approximately 1 per 1,000 central line days.
Additionally, the study demonstrated that among the 286 CLABSIs, the most common organism was Staphylococcus aureus (n = 49, 17%), followed by Staphylococcus epidermidis (n = 42, 15%), Escherichia coli (n = 22, 8%) and Pseudomonas species (n =22, 8%).
“ISI is probably a better way to monitor central line care and maintenance efforts. ISI surveillance can also help compare central line prevention efforts across different hospitals.”
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