Summary
Background
Central-line-associated bloodstream infections (CLABSIs) are serious healthcare-associated
infections with substantial morbidity and hospital costs.
Aim
To investigate the association between the incidence of CLABSIs, the implementation
of specific infection control measures, and the incidence of multi-drug-resistant
(MDR) bacteraemias in a tertiary care hospital in Greece from 2013 to 2018.
Methods
Analysis was applied for the following indices, calculated monthly: CLABSI rate; use
of hand hygiene disinfectants; isolation rate of patients with MDR bacteria; and incidence
of bacteraemias [total Gram-negative carbapenem-resistant Acinetobacter baumanii, carbapenem-resistant Pseudomonas aeruginosa and carbapenem-resistant Klebsiella pneumoniae; and Gram-positive meticillin-resistant Staphylococcus aureus and vancomycin-resistant enterococci].
Findings
The total number of bacteraemias from carbapenem-resistant Gram-negative pathogens
was significantly correlated with an increased CLABSI rate for all (total) hospital
departments [incidence rate ratio (IRR) 1.17, 95% confidence interval (CI) 1.05–1.31,
P=0.006] and the adult intensive care unit (ICU) (IRR 1.37, 95% CI 1.07–1.75, P=0.013). In the adult ICU, every increase in the incidence of each resistant Gram-negative
pathogen was significantly correlated with a decreased CLABSI rate (carbapenem-resistant
A. baumanii: IRR 0.59, 95% CI 0.39–0.90, P=0.015; carbapenem-resistant K. pneumoniae: IRR 0.48, 95% CI 0.25–0.94, P=0.031; carbapenem-resistant P. aeruginosa: IRR 0.54, 95% CI 0.33–0.89, P=0.015). The use of hand disinfectants was correlated with a decreased CLABSI rate
1–3 months before the application of this intervention for all (total) hospital departments
(IRR 0.80, 95% CI 0.69–0.93, P=0.005), and for scrub disinfectants in the current month for the adult ICU (IRR 0.34,
95% CI 0.11–1.03, P=0.057). Isolation of patients with MDR pathogens was not associated with the incidence
of CLABSIs.
Conclusion
Hand hygiene was associated with a significant reduction in the incidence of CLABSIs
at the study hospital. Time-series analysis is an important tool to evaluate infection
control interventions.
Keywords
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Article info
Publication history
Published online: February 08, 2022
Accepted:
January 29,
2022
Received:
November 29,
2021
Identification
Copyright
© 2022 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.
