March 01, 2011
Today s Vital Signs report from the CDC contains some intriguing statistics on central-line associated bloodstream infections (CLABSIs) in ICUs, wards, and outpatient hemodialysis settings.
CLABSIs are a particularly dangerous form of healthcare associated infection (HAI) 12 to 25% of patients who acquire a bloodstream infection from a central line die but they are largely preventable. Despite this, CLABSIs persist as a serious problem in hospitals and outpatient settings.
Today’s release from the CDC does find that significant progress has been made in reducing CLABSIs in ICUs–infection rates have decreased by 58% from 2001 to 2009, resulting in an estimated 6,000 lives saved in 2009 and a cumulative $1.8 billion in averted health-care costs over the period.
But many CLABSIs continue to occur outside of ICU and hospital settings. Approximately one in ten hemodialysis patients acquire CLABSIs, and infections are among the leading causes of hospitalization and death for these patients. With the number of patients on dialysis expected to increase dramatically in the coming years, these numbers are particularly concerning. The report findings point to a clear need for action beyond ICUs. Fortunately, we have a prevention model focused on full collaboration that can be applied broadly to maximize prevention efforts, said Denise Cardo, M.D., director of CDC s Division of Healthcare Quality Promotion.
Take-home messages from the report include:
- Central lines should be used only when essential, and when they are used, providers should adhere to best practices. New infection prevention measures are needed, particularly in outpatient hemodialysis settings.
- There is a need for further research into specific disease-causing pathogens. The report found that CLABSIs resulting from S. aureus infections decreased more than CLABSIs resulting from other organisms, yet factors behind this decline remain largely unexplored. Research is also needed to target organisms that are not declining.
- Public reporting and monitoring of HAIs through the National Healthcare Safety Network (NHSN) is a critical element of CLABSIs prevention going forward. In the United States, 28 states currently mandate public reporting 21 do so through NHSN. Utilizing NHSN as a reporting mechanism encourages standardization of definitions and methods. Read about the current status of state reporting programs.
Learn more about Vital Signs and the prevention of CLABSIs in healthcare settings.
