Type of Health Care-Associated Infections Is Falling

Central line-associated blood stream infections decline in ICUs; still high elsewhere

TUESDAY, March 1 (HealthDay News) -- The incidence of central line-associated blood stream infections (CLABSIs) in intensive care units (ICUs) has decreased by more than half since 2001, but the infections continue to occur in substantial numbers in inpatient wards and outpatient hemodialysis centers, according to research published in the March 1 early-release issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

Arjun Srinivasan, M.D., of the CDC in Atlanta, and colleagues multiplied central-line utilization and CLABSI rates by the total number of patient-days in ICUs, inpatient wards, and outpatient hemodialysis facilities to estimate the number of CLABSIs in each setting.

In ICU patients, the number of CLABSIs fell dramatically from an estimated 43,000 in 2001 to 18,000 in 2009. The researchers note that reductions in CLABSIs due to Staphylococcus aureus were more pronounced than declines in infections caused by gram-negative rods, Candida spp., and Enterococcus spp. Numbers for inpatient wards in 2009 and outpatient hemodialysis in 2008 remained fairly high, at 23,000 and 37,000, respectively. According to the report, the reduction in CLABSIs in ICUs represents as many as 6,000 lives saved and $414 million in potential excess health care costs in 2009 as well as approximately $1.8 billion in cumulative excess health care costs since 2001.

"Continued success in CLABSI prevention will require increased adherence to current CLABSI prevention recommendations, development and implementation of additional prevention strategies, and the ongoing collection and analysis of data, including specific microbiologic information. To prevent CLABSIs in hemodialysis patients, efforts to reduce central line use for hemodialysis and improve the maintenance of central lines should be expanded," the authors write.

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