Surveillance of central-line associated bloodstream infections in ICU at a Malaysian medical centre
© Sulong et al; licensee BioMed Central Ltd. 2011
Published: 29 June 2011
Introduction / objectives
We conducted a prospective surveillance study to determine the incidence and epidemiology of CLABSI in the intensive care unit (ICU) at a tertiary teaching medical centre using CDC definition of a bloodstream infection that develops in a patient who had a central line at the time of, or within 48 hours before, the onset of the infection.
A cross section observational study was conducted in a 24-bed GICU over 10-months period from April 2008 until January 2009 among patients with central venous catheters (CVCs) inserted in the ICU or operation theatre.
A total of 20 CLABSI cases were identified among 155 CVCs in 100 patients with 3106 catheter days. The overall rate of CLABSI was 6.4 per 1000 catheter-days and device-utilization (DU) ratio of 0.81. The mean length of ICU stay for CLABSI and non- CLABSI cases was 37.2 days and 17.4 days respectively, while the median length of ICU stay for CLABSI cases was 16.0 days and for non- CLABSI cases was 10.0 days. This contributed to 6 extra days of ICU stay in CLABSI cases. CVCs inserted via the femoral vein were associated with higher infection rate of 22.2% followed by those of internal jugular vein (15.4%) and subclavian vein (5.1%). Gram-negative bacteria accounted for 50% of the CLABSI cases whereas gram-positive cocci and fungi caused 35% and 15% of these infections respectively.
Both of the CLABSI rate of 6.4 per 1000 catheter-days and DU ratio of 0.81 were above the 90th percentile of the NHSN benchmark. Comparing our findings to the INNIC 2003-2008 studies with 7.4 CLABSI per 1000 catheter-days, our CLABSI rate was lower. However, our DU ratio was higher. Hence, interventions aimed at improving outcomes related to CVCs should seriously be considered.
Disclosure of interest
This article is published under license to BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.