Reducing central-line-associated bloodstream infections by half: it is possible

Abstract

Healthcare-associated bloodstream infection (BSI) and especially central-line-associated bloodstream infection (CLABSI) are known to be preventable in up to 70% of cases [ 1 Pronovost P.J. Watson S.R. Goeschel C.A. Hyzy R. Berenholtz S. Sustaining reductions in central-line associated bloodstream infections in Michigan intensive care units: a 10-year analysis. Am J Med Qual. 2016; 31: 197-202 Crossref PubMed Scopus (63) Google Scholar , 2 Latif A.L. Kelly B. Edrees H. Kent P. Weaver S. Jovanovic B. et al. Implementing a multifaceted intervention to decrease central line associated bloodstream infection in SEHA (Abu Dhabi Health Services Company) intensive care units: the Abu Dhabi experience. Infect Control Hosp Epidemiol. 2015; 36: 816-822 Crossref PubMed Scopus (21) Google Scholar , 3 Umscheid C.A. Mitchell M.D. Doshi J.A. Agarwal R. Williams K. Brennan P. Estimating the proportion of healthcare-associated infections that are reasonably preventable and the related mortality and costs. Infect Control Hosp Epidemiol. 2011; 32: 101-114 Crossref PubMed Scopus (673) Google Scholar ]. In acute care hospitals, mean CLABSI rates of 1.44–20.90 per 1000 central-line-days (CLD) in the intensive care units (ICUs) of the International Nosocomial Infection Control Consortium (2010–2015) have been reported [ [4] Rosenthal V. Al-Abdely H. El-Kholy A.A. Aziz AlKhawaja S.A. Leblebicioglu H. Mehta Y. et al. International Nosocomial Infection Control Consortium report, data summary of 50 countries for 2010–2015: device-associated module. Am J Infect Control. 2016; 44: 1495-1504 Abstract Full Text Full Text PDF PubMed Scopus (182) Google Scholar ]. The Belgian incidence of healthcare-associated BSI, at 8.4 per 10,000 patient-days, has changed little during recent years in acute care hospitals (www.nsih.be). One healthcare-associated BSI out of four was classified as CLABSI. At University Hospitals Leuven, surveillance of CLABSI started in the year 2012. Because of an initially high CLABSI rate of 4.4 and 6.1 per 1000 CLD in non-ICU and ICU units respectively, a hospital-wide quality improvement project was initiated.