High Prevalence of Reduced Chlorhexidine Susceptibility in Organisms Causing Central Line–Associated Bloodstream Infections

2014 ◽  
Vol 35 (9) ◽  
pp. 1183-1186 ◽  
Author(s):  
Nuntra Suwantarat ◽  
Karen C. Carroll ◽  
Tsigereda Tekle ◽  
Tracy Ross ◽  
Lisa L. Maragakis ◽  
...  
Keyword(s):  
Bloodstream Infections ◽  
Central Line ◽  
Chlorhexidine Gluconate ◽  
Infect Control Hosp ◽  
High Prevalence

In units that bathe patients daily with chlorhexidine gluconate (CHG), organisms causing central line–associated bloodstream infections (CLABSIs) were more likely to have reduced CHG susceptibility than organisms causing CLABSIs in units that do not bathe patients daily with CHG (86% vs 64%; P = .028). Surveillance is needed to detect reduced CHG susceptibility with widespread CHG use.Infect Control Hosp Epidemiol 2014;35(9):1183-1186

Risk Factors for Central Line–Associated Bloodstream Infections in the Era of Prevention Bundles

2014 ◽  
Vol 36 (2) ◽  
pp. 214-216 ◽  
Author(s):  
Devin Callister ◽  
Pauline Limchaiyawat ◽  
Samantha J. Eells ◽  
Loren G. Miller
Keyword(s):  
Risk Factors ◽  
Bloodstream Infection ◽  
Hemodynamic Monitoring ◽  
Bloodstream Infections ◽  
Central Line ◽  
Infection Risk ◽  
Case Control ◽  
Infect Control Hosp ◽  
Infection Risk Factors ◽  
Independent Risk Factors

Little is known about central line–associated bloodstream infection risk factors in the bundle era. In our case-control investigation, we found that independent risk factors for central line–associated bloodstream infection at our center included the number of recent lab tests, catheter duration, and lack of hemodynamic monitoring as the insertion indication.Infect Control Hosp Epidemiol 2014;00(0): 1–3

The use of 3.15% chlorhexidine gluconate/70% alcohol hub disinfection to prevent central line-associated bloodstream infections in dialysis patients

2020 ◽  
Vol 29 (2) ◽  
pp. S24-S26 ◽  
Author(s):  
R. Marty Cooney ◽  
Nisha Manickam ◽  
Paul Becherer ◽  
Laura S. Harmon ◽  
Liza Gregg ◽  
...  
Keyword(s):  
Vascular Grafts ◽  
Bloodstream Infections ◽  
Venous Catheter ◽  
Central Line ◽  
Chlorhexidine Gluconate ◽  
P Value ◽  
Dialysis Patients ◽  
Skin Disinfection ◽  
Confounding Variables ◽  
Inpatient Population

Purpose: Preventing CLABSI events in the dialysis inpatient population represents significant challenges. Bacteremia associated with lines or grafts are common health-associated infections that lead to adverse patient outcomes. Dialysis patients represent a much higher infection risk due to health frequency needs, more frequent hospitalizations, multiple comorbidity issues, fistula functionality, and multiple attempts for line access leading to additional complications, costs, morbidity, and mortality. Methods: An observational study was conducted including central line device days, CLABSI events, and possible confounding variables in admitted dialysis patients. All CLABSI data were identified according to the Centers for Disease Control and Prevention's National Healthcare Safety Network's definitions for CLABSIs. The intervention involved the removal of 70% alcohol swabs and alcohol hub disinfecting caps, then replacing with swabs containing 3.15% chlorhexidine gluconate/70% alcohol for central line hub disinfection and vascular graft access skin disinfection. Results: The 5-year preintervention period (2008–2012) involved 7568 central line days, 11 CLABSI events, and a 1.45 per 1000 device day rate. The 6-month trial period involved 1559 central line days and no CLABSI events. The 5-year postimplementation period (2013–2017) involved 9787 central line days, 5 CLABSI events, and a 0.51 per 1000 device day rate. The postimplementation period represented a statistically significant (P value=0.0493) reduction with 65% fewer CLABSI events compared with the preimplementation period. Limitations: A limitation was variations in scrub time and dry time during central venous catheter hub access. While we were comparing 2 products, behavioral practices using these 2 products were possible influencers and represent a possible confounding variable. Conclusions: This study found that using alcohol with chlorhexidine gluconate prior to accessing central line hubs and vascular grafts allows for reduction in CLABSI events and sustains statistically significant lower CLABSI rates in the inpatient dialysis population. HIGHLIGHTS Using alcohol with chlorhexidine gluconate (CHG) before accessing central line hubs helps reduce central line-associated bloodstream infection (CLABSI) events Using alcohol with CHG before accessing vascular grafts helps reduce CLABSI events A statistically significant reduction (65%) in CLABSI events occurred after use. Statistically significant lower CLABSI rates are sustainable with use of alcohol with CHG

Distribution of Central Line-Associated Bloodstream Infections Determined From Washington State’s Annual Reporting Validation Program, 2009–2013

2016 ◽  
Vol 38 (4) ◽  
pp. 489-492
Author(s):  
Jason M. Lempp ◽  
M. Jeanne Cummings ◽  
David W. Birnbaum
Keyword(s):  
Bloodstream Infection ◽  
Healthcare Quality ◽  
Bloodstream Infections ◽  
Central Line ◽  
Infect Control Hosp ◽  
Public Healthcare ◽  
Healthcare Associated Infection ◽  
Reporting Accuracy ◽  
Annual Reporting ◽  
Healthcare Associated

Healthcare-associated infection reporting validation is essential because this information is increasingly used in public healthcare quality assurances and care reimbursement. Washington State’s validation of central line-associated bloodstream infection reporting applies credible quality sciences methods to ensure that hospital reporting accuracy is maintained. This paper details findings and costs from our experience.Infect Control Hosp Epidemiol 2017;38:489–492

Journey to Zero Central Line-Associated Bloodstream Infections: An Intensive Care Unit's Story of Sustained Success and Quality Improvement

2016 ◽  
Vol 21 (2) ◽  
pp. 76-80 ◽  
Author(s):  
Leighann Jock ◽  
Laurie Emery ◽  
Lorri Jameson ◽  
Phyllis A. Woods
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Bloodstream Infections ◽  
Central Line ◽  
Chlorhexidine Gluconate ◽  
Staff Education ◽  
Increased Risk ◽  
The Face ◽  
Sustained Success ◽  
Clabsi Rate

Abstract Background: Patients who have a central line (CL) are at increased risk for developing a CL-associated bloodstream infection (CLABSI), which increases morbidity, length of stay, and cost. Our goal is zero CLABSI infections. Methodology: In 2009 our organization implemented a CL bundle to prevent CLABSIs, and staff education was introduced in 2012. In 2013 a 2% chlorhexidine gluconate (CHG) wipe was introduced and used to clean around CL dressings. In 2014 a new CL dressing was adopted and during 2015 the organization began using a 3.15% CHG/70% alcohol swab for disinfection of needleless connectors. A final intervention was put into place in 2015 called “nose to toes” in which a patient is bathed from nose to toes (excluding the face) using 2% CHG wipes. Results: Before implementation of the above methods, our intensive care unit had an average infection rate of 1.9/1000 CL-days in 2009. Incidence of CLABSIs continued to decrease as the organization implemented the additional products and practices. In the 15 months following implementation, the ICU has been able to consistently maintain a zero CLABSI rate. Conclusions: The implementation of these changes in practice along with bringing in new products has made it possible to achieve the goal of reaching and maintaining zero infections. Due to the successful results in our intensive care unit, we have implemented these changes to all patient care areas in the hospital for use on all CLs.

scholarly journals The Use of 3.15% Chlorhexidine Gluconate/70% Alcohol Hub Disinfection to Prevent Central Line-Associated Bloodstream Infections in Dialysis Patients

2019 ◽  
Vol 24 (4) ◽  
pp. 33-36
Author(s):  
R. Marty Cooney ◽  
Nisha Manickam ◽  
Paul Becherer ◽  
Laura S. Harmon ◽  
Liza Gregg ◽  
...  
Keyword(s):  
Vascular Grafts ◽  
Bloodstream Infections ◽  
Central Line ◽  
Chlorhexidine Gluconate ◽  
Dialysis Patients

Highlights Using alcohol with CHG before accessing central line hubs helps reduce CLABSI events. Using alcohol with CHG before accessing vascular grafts helps reduce CLABSI events. A statistically significant reduction (65%) in CLABSI events occurred after use. Statistically significant lower CLABSI rates are sustainable with use of alcohol with CHG.

Unnecessary Removal of Central Venous Catheters in Cancer Patients with Bloodstream Infections

2018 ◽  
Vol 39 (2) ◽  
pp. 222-225 ◽  
Author(s):  
Anne Marie Chaftari ◽  
Ray Hachem ◽  
Sammy Raad ◽  
Ying Jiang ◽  
Elizabeth Natividad ◽  
...  
Keyword(s):  
Central Venous Catheter ◽  
Cancer Patients ◽  
Vascular Access ◽  
Bloodstream Infections ◽  
Venous Catheter ◽  
Central Line ◽  
Central Venous Catheters ◽  
Infect Control Hosp ◽  
Physician Education ◽  
Central Venous

We evaluated the rate of central venous catheter (CVC) removal in 283 cancer patients with bloodstream infections (BSIs). Removal of CVCs occurred unnecessarily in 57% of patients with non-central-line-associated BSI (non-CLABSI), which was equivalent to the rate of CVC removal in patients with CLABSIs. Physician education and safe interventions to salvage the vascular access are warranted.Infect Control Hosp Epidemiol 2018;39:222–225

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