Prevention of central line associated bloodstream infections in critical care units

2011 ◽  
Vol 23 (1) ◽  
pp. 85-90 ◽  
Author(s):  
Simon Li ◽  
Matthew J Bizzarro
Keyword(s):  
Critical Care ◽  
Bloodstream Infections ◽  
Central Line ◽  
Critical Care Units

Data Analytics for Diagnosis and Prediction of Central Line–Associated Bloodstream Infections in Critical Care Units

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Mary A. Hooshmand ◽  
Christine Susana Toledo ◽  
Ramin Moghaddas ◽  
Erotokritos Skordilis
Keyword(s):  
Critical Care ◽  
Data Analytics ◽  
Bloodstream Infections ◽  
Central Line ◽  
Critical Care Units

scholarly journals Impact of Critical Care Consultation Requests for Avoidable Central Venous Catheters on Medical-Surgical Units

2020 ◽  
Vol 41 (S1) ◽  
pp. s258-s258
Author(s):  
Madhuri Tirumandas ◽  
Theresa Madaline ◽  
Gregory David Weston ◽  
Ruchika Jain ◽  
Jamie Figueredo
Keyword(s):  
Critical Care ◽  
High Risk ◽  
Medical Center ◽  
Academic Medical Center ◽  
Retrospective Chart Review ◽  
Bloodstream Infections ◽  
Central Line ◽  
Central Venous Catheters ◽  
High Risk Population ◽  
Central Venous

Background: Although central-line–associated bloodstream infections (CLABSI) in US hospitals have improved in the last decade, ~30,100 CLABSIs occur annually.1,2 Central venous catheters (CVC) carry a high risk of infections and should be limited to appropriate clinical indications.6,7 Montefiore Medical Center, a large, urban, academic medical center in the Bronx, serves a high-risk population with multiple comobidities.8–11 Despite this, the critical care medicine (CCM) team is often consulted to place a CVC when a peripheral intravenous line (PIV) cannot be obtained by nurses or primary providers. We evaluated the volume of CCM consultation requests for avoidable CVCs and related CLABSIs. Methods: Retrospective chart review was performed for patients with CCM consultation requests for CVC placement between July and October 2019. The indication for CVC, type of catheter inserted or recommended, and NHSN data were used to identify CLABSIs. CVCs were considered avoidable if a PIV was used for the stated indication and duration of therapy, with no anatomical contraindications to PIV in nonemergencies, according to the Michigan Appropriateness Guide for Intravenous Catheters (MAGIC).6Results: Of 229 total CCM consults, 4 (18%) requests were for CVC placement; 21 consultations (9%) were requested for avoidable CVCs. Of 40 CVC requests, 18 (45%) resulted in CVC placement by the CCM team, 4 (10%) were deferred for nonurgent PICC by interventional radiology, and 18 (45%) were deferred in favor of PIV or no IV. Indications for CVC insertion included emergent chemotherapy (n = 8, 44%) and dialysis (n = 3, 16%), vasopressors (n = 3, 16%), antibiotics (n = 2, 11%) and blood transfusion (n = 2, 11%). Of 18 CVCs, 9 (50%) were potentially avoidable: 2 short-term antibiotics and rest for nonemergent indications; 2 blood transfusions, 1 dialysis, 2 chemotherapy and 2 vasopressors. Between July and October 2019, 6 CLABSIs occurred in CVCs placed by the CCM team; in 3 of 6 CLABSI events (50%), the CVC was avoidable. Conclusions: More than half of consultation requests to the CCM team for CVCs are avoidable, and they disproportionately contribute to CLABSI events. Alternatives for intravenous access could potentially avoid 9% of CCM consultations and 50% of CLABSIs in CCM-inserted CVCs on medical-surgical wards.Funding: NoneDisclosures: None

scholarly journals Rapid Diagnostics for Blood Cultures: Supporting Decisions for Antimicrobial Therapy and Value-Based Care

2019 ◽  
Vol 3 (4) ◽  
pp. 686-697 ◽  
Author(s):  
Donna M Wolk ◽  
J Kristie Johnson
Keyword(s):  
Critical Care ◽  
Antibiotic Therapy ◽  
Bloodstream Infections ◽  
Blood Cultures ◽  
Rapid Diagnostics ◽  
Clinical Practices ◽  
Critical Care Units ◽  
The Us ◽  
Causes Of Mortality ◽  
Value Based Care

Abstract Bacteremia and sepsis are critically important syndromes with high mortality, morbidity, and associated costs. Bloodstream infections and sepsis are among the top causes of mortality in the US, with >600 deaths each day. Most septic patients can be found in emergency medicine departments or critical care units, settings in which rapid administration of targeted antibiotic therapy can reduce mortality. Unfortunately, routine blood cultures are not rapid enough to aid in the decision of therapeutic intervention at the onset of bacteremia. As a result, empiric, broad-spectrum treatment is common—a costly approach that may fail to target the correct microbe effectively, may inadvertently harm patients via antimicrobial toxicity, and may contribute to the evolution of drug-resistant microbes. To overcome these challenges, laboratorians must understand the complexity of diagnosing and treating septic patients, focus on creating algorithms that rapidly support decisions for targeted antibiotic therapy, and synergize with existing emergency department and critical care clinical practices put forth in the Surviving Sepsis Guidelines.

Critical Care Leads the Way in the Prevention of Central Line Associated Bloodstream Infections

2011 ◽  
Vol 39 (5) ◽  
pp. E196
Author(s):  
Vicky M. Ferris ◽  
Kathleen M. McMullen ◽  
Anthony J. Russo ◽  
Helen A. Wood ◽  
Michael A. Lane
Keyword(s):  
Critical Care ◽  
Bloodstream Infections ◽  
Central Line ◽  
The Way

Strategies to Reduce Central Line-associated Bloodstream Infections in a Critical Care Unit

2017 ◽  
Vol 45 (6) ◽  
pp. S112
Author(s):  
Nancy Hickox ◽  
Latrice Clifton ◽  
Chamele Coe ◽  
Frederick Cox ◽  
Mary Gardenhire ◽  
...  
Keyword(s):  
Critical Care ◽  
Critical Care Unit ◽  
Bloodstream Infections ◽  
Central Line

Achieving a Zero Central Line-Associated Bloodstream Infection Rate in 4 Critical Care Units in Lebanon

2019 ◽  
Vol 42 (5) ◽  
pp. 249-253
Author(s):  
Sabath Jamous ◽  
Iman Kouatly ◽  
Rafika Zaatari ◽  
Lina Kurdahi Badr
Keyword(s):  
Critical Care ◽  
Bloodstream Infection ◽  
Infection Rate ◽  
Central Line ◽  
Critical Care Units

scholarly journals 1179. Rates and Causative Pathogens of Device-Associated Bloodstream and Urinary Tract Infections Attributed to Solid-Organ Transplant Units, 2015–2017

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S422-S423
Author(s):  
Nora Chea ◽  
Liang Zhou ◽  
Shelley Magill ◽  
Alice Guh ◽  
Jonathan R Edwards ◽  
...  
Keyword(s):  
Critical Care ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Statistical Significance ◽  
Organ Transplant ◽  
Central Line ◽  
Solid Organ Transplant ◽  
Solid Organ ◽  
Critical Care Units ◽  
Tract Infections

Abstract Background Due to complex invasive medical procedures and compromised immunity, solid-organ transplant (SOT) patients are at high risk for infections. However, whether SOT patients are at higher risk than other hospitalized patients for selected healthcare-associated infections (HAI), such as central line-associated bloodstream infections (CLABSI) or catheter-associated urinary tract infections (CAUTI), or for infections with antimicrobial-resistant (AR) pathogens, is not well described. We analyzed data reported to the Centers for Disease Control and Prevention’s (CDC’s) National Healthcare Safety Network (NHSN) from inpatient SOT units and compared CLABSI and CAUTI rates and AR in hospitals with both SOT and non-SOT units. Methods We analyzed 2015–2017 CLABSI and CAUTI data reported to NHSN from hospitals with adult or pediatric inpatient SOT units. We calculated CLABSI and CAUTI incidence rates per 1,000 central-line days (CLD) and urinary catheter days (UCD), respectively, and compared rates, pathogen distributions, and AR among events attributed to three unit types: (1) SOT units; (2) adult, pediatric, and neonatal critical care units; and (3) adult and pediatric medical, surgical, and combined medical-surgical wards. We compared proportions using χ 2 tests and determined statistical significance at P ≤ 0.05. Results CLABSI and CAUTI rates in SOT units were lower than rates in critical care units, but higher than rates in wards (table). Although the most common CLABSI and CAUTI pathogens were similar in all three unit types, the prevalence of individual pathogens differed (figure). Among CLABSI pathogens, Enterococcus faecium, Escherichia coli, and Klebsiella pneumoniae or oxytoca were significantly more prevalent in SOT compared with critical care units. Vancomycin resistance among CLABSI E. faecium was significantly lower (71.4% vs. 87.5%) and fluoroquinolone resistance among CAUTI E. coli was significantly higher (49.3% vs. 32.5%) in SOT compared with critical care units. Conclusion SOT units have lower CLABSI and CAUTI rates compared with critical care units. Differences in pathogens and AR among device-associated HAIs in SOT units should be considered when implementing infection prevention and treatment policies. Disclosures All authors: No reported disclosures.

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