Journal of Korean Medical Science

Korean Acad Medical Sciences (대한의학회)
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Two-Year Hospital-Wide Surveillance of Central Line-Associated Bloodstream Infections in a Korean Hospital

  • Seo, Hye Kyung (Infection Control Office, Seoul National University Bundang Hospital) ;
  • Hwang, Joo-Hee (Department of Internal Medicine, Seoul National University Bundang Hospital) ;
  • Shin, Myoung Jin (Infection Control Office, Seoul National University Bundang Hospital) ;
  • Kim, Su young (Infection Control Office, Seoul National University Bundang Hospital) ;
  • Song, Kyoung-Ho (Department of Internal Medicine, Seoul National University Bundang Hospital) ;
  • Kim, Eu Suk (Infection Control Office, Seoul National University Bundang Hospital) ;
  • Kim, Hong Bin (Department of Internal Medicine, Seoul National University Bundang Hospital)
  • Received : 2018.02.27
  • Accepted : 2018.07.13
  • Published : 2018.11.05
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Abstract

Background: Surveillance and interventions of central line-associated bloodstream infections (CLABSIs) had mainly been targeted in intensive care units (ICUs). Central lines are increasingly used outside ICUs. Therefore, we performed a hospital-wide survey of CLABSIs to evaluate the current status and develop strategies to reduce CLBASI rates. Methods: All hospitalized patients with central venous catheters (CVCs) were screened for CLABSIs from January 2014 through December 2015 at a 1,328 bed tertiary care teaching hospital in Korea using an electronic data-collecting system. Clinical information including type of CVC was collected. CLABSI rates were calculated using the definitions of the National Health and Safety Network after excluding mucosal barrier injury laboratory-confirmed bloodstream infection (BSI). Results: A total of 154 CLABSIs were identified, of which 72 (46.8%) occurred in general wards and 82 (53.2%) in ICUs (0.81 and 2.71 per 1,000 catheter days), respectively. Nontunneled CVCs were most common (68.6%) among 70 CLABSI events diagnosed within one week of their maintenance. On the other hand, tunneled CVCs and peripherally inserted central catheters (PICCs) were more common (60.5%) among 114 CLABSI events diagnosed more than a week after maintenance. Whereas the majority (72.2%) of CLABSIs in ICUs were associated with non-tunneled CVCs, tunneled CVCs (38.9%) and PICCs (36.8%) were more common in general wards. Conclusion: CLABSIs are less common in general wards than in ICUs, but they are more often associated with long-term indwelling catheters. Therefore, interventions to prevent CLABSIs should be tailored according to the type of ward and type of catheter.

Keywords

References

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