Central Line-Associated Bloodstream Infections

(CLABSI)
  • Definition

    A central line-associated bloodstream infection (CLABSI) occurs when bacteria enters the bloodstream through a central line catheter . A central line catheter is a long, thin tube that is inserted through a vein until it reaches a larger vein close to the heart. It is used to deliver medication, nutrition, IV fluids, and chemotherapy .
    Chemotherapy Through the Bloodstream
    Chemotherapy
    A central line catheter can be used to deliver chemotherapy .
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    If bacteria start to grow on the central line catheter, they can easily enter the blood and cause a serious infection. This can lead to a condition called sepsis , which occurs when bacteria overwhelm the body.
  • Causes

    Bacteria normally live on the skin. These bacteria will sometimes track along the outside of the catheter. From the catheter, they can get into the bloodstream.
  • Risk Factors

    These factors increase your chance of developing a CLABSI:
    • Having a catheter for a long time
    • Having a catheter that is not coated with an antimicrobial—a substance that kills bacteria
    • Having a catheter inserted into a vein in the thigh
    • Having a weakened immune system
    • Being in the intensive care unit
    • Having an infection elsewhere in the body or skin
  • Symptoms

    Symptoms of CLABSI may include:
    • Fever
    • Chills
    • Fast heart rate
    • Redness, swelling, or tenderness at the catheter site
    • Drainage from catheter site
  • Diagnosis

    Your doctor will ask about your symptoms and medical history. A physical exam will be done.
    Your bodily fluids may be tested. This can be done with:
    • Blood tests and cultures
    • Urine tests
    • Sputum tests
    Your heart may need to be viewed. This can be done with echocardiogram .
  • Treatment

    Talk with your doctor about the best treatment plan for you. Treatment options include the following:
    • Antibiotics—Antibiotics are medications used to treat an infection. The kind of antibiotic you will be given depends on which bacteria is found in your blood.
    • Central line care—Often, the central line catheter will need to be removed and replaced by a new catheter.
  • Prevention

    At the Hospital
    When you are getting a central line placed, the staff will follow a series of steps to reduce your risk of infection.
    There are also steps that you can take to reduce your risk of infection:
    • Ask the staff to take every precaution to prevent an infection.
    • Tell the staff right away if the bandage needs to be changed or if the site is red or sore.
    • Ask everyone entering your hospital room to wash their hands. Do not allow visitors to touch your catheter.
    At Home
    • Follow all instructions concerning your central line.
    • Learn how to take care of your catheter. Follow these general guidelines:
      • Follow specific instructions about showering and bathing.
      • Before touching the catheter, wash your hands or use a hand sanitizer. Wear gloves when touching the area.
      • Change bandages as directed.
      • Wash the catheter caps with an antiseptic.
      • Do not allow anyone to touch the catheter or the tube.
      • Check the insertion site daily for signs of infection, such as redness and swelling.
      • Call your doctor if you think you have an infection.
  • RESOURCES

    Centers for Disease Control and Prevention http://www.cdc.gov

    Society of Critical Care Medicine http://www.sccm.org

    CANADIAN RESOURCES

    Health Canada http://www.hc-sc.gc.ca

    Safer Healthcare Now! http://www.saferhealthcarenow.ca

    References

    Central venous catheter. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Updated July 25, 2013. Accessed August 8, 2013.

    Central venous catheterization. American Thoracic Society website. Available at: http://www.thoracic.org/clinical/critical-care/patient-information/icu-devices-and-procedures/central-venous-catheterization.php . Accessed August 8, 2013.

    FAQs: Catheter-associated bloodstream infections. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/hai/pdfs/bsi/BSI%5Ftagged.pdf . Accessed August 8, 2013.

    Marschall J, Mermel LA, Classen D, et al. Strategies to prevent central line-associated bloodstream infections in acute care hospitals. Infect Control Hosp Epidemiol. 2008;29 Suppl 1:S22-30.

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