Frequency Determination of Central Line Associated Bloodstream Infection at a Renal Care Centre

Abstract

Background: Central line-associated bloodstream infection (CLABSI) is a serious infection typically increasing morbidity and mortality in patients with chronic kidney disease (CKD). It can be prevented through proper insertion techniques and management of the central line (CL). However, the first step in reducing the CLABSI rate is to define the extent of the problem through proper surveillance. This study aimed to determine the frequency of CLABSI in patients with CKD at a specialised renal care centre. Methods: The authors conducted a retrospective observational study to determine the frequency of CLABSI in patients with CKD between November 2021–September 2022 at their institute. They included all patients with CLs registered at their institute. Primary CLABSI was defined as CLABSI attributable to their hospital, while secondary CLABSI was defined as those not attributed to their hospital. Results: Fifty-nine incidences of CLABSI were identified in a total of 310 patients with CL and 1,413 CL days, giving a total of 42 CLABSI incidences per 1,000 CL days. Primary CLABSI was more common (n=36 [61%]) than secondary CLABSI (n=23 [39%]). Most of the patients recovered (53 [89.8%]); however, four (6.9%) patients expired. Most of the patients who recovered had permanent vascular access (n=32 [60.4%]), internal jugular placement (n=44 [83%]), and primary CLABSI (n=33 [62.3%]), although the p-values were non-significant. Conclusion: Strict implementation of CLABSI prevention bundles for line insertion and its maintenance and regular surveillance using laboratory confirmed cases is needed to reduce the rates of CLABSI.