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Central line-associated bloodstream infection prevention

Miller, Sarah E.a; Maragakis, Lisa L.a,b

Current Opinion in Infectious Diseases: August 2012 - Volume 25 - Issue 4 - p 412–422
doi: 10.1097/QCO.0b013e328355e4da
NOSOCOMIAL AND HEALTHCARE RELATED INFECTIONS: Edited by Trish M. Perl

Purpose of review: This review summarizes recent literature regarding the prevention of central line-associated bloodstream infection (CLABSI).

Recent findings: CLABSI rates in United States ICUs reported to the National Healthcare Safety Network (NHSN) have decreased dramatically in recent years. This has been achieved largely through a multifaceted approach and a focus on evidence-based best practices for central line insertion. More recent studies suggest an added benefit from implementation of evidence-based best practices for central line maintenance. Recent investigations also focus on CLABSI prevention among pediatric patients and in the non-ICU setting, in which a significant proportion of central line-days and CLABSI occur. A recent meta-analysis supports the practice of daily chlorhexidine gluconate (CHG) bathing in the ICU population for CLABSI prevention. Investigation continues regarding the most effective way to implement and sustain CLABSI prevention practices, including ways to best address and improve the culture of safety in healthcare.

Summary: Recent literature on CLABSI prevention shows that a multifaceted approach to improving central line insertion and maintenance practices results in decreased CLABSI rates in both the ICU and non-ICU settings. More data are needed to develop appropriate benchmarks and prevention strategies specific to the non-ICU setting, in which a significant proportion of central line-days and CLABSI occur.

aDepartment of Medicine, Division of Infectious Diseases, Johns Hopkins University School of Medicine

bDepartment of Hospital Epidemiology and Infection Control, Johns Hopkins Hospital, Baltimore, Maryland, USA

Correspondence to Sarah E. Miller, MD, Fellow, Division of Infectious Diseases, Johns Hopkins University, 600 North Wolfe Street, Osler 425, Baltimore, MD 21287, USA. Tel: +1 410 955 8384; fax: +1 410 614 0888; e-mail: smill106@jhmi.edu

© 2012 Lippincott Williams & Wilkins, Inc.