Intravascular catheter bloodstream infections: an effective and sustained hospital-wide prevention program over 8 years.
OBJECTIVE
To evaluate a hospital-wide surveillance and intervention program introduced to reduce the incidence of bloodstream infections (BSIs) caused by intravascular (IV) catheters.


METHODS
Prospective surveillance of all inpatients and outpatient attendees with positive blood cultures (both hospital-onset and community-onset) at a 500-bed tertiary referral hospital from 1998 to 2005.


METHODS
Prompt review of all positive blood cultures with identification of BSIs due to IV catheters and associated preventable factors; weekly team meetings and regular reports to clinical areas, with assistance to implement targeted interventions.


METHODS
Number of BSI episodes due to IV catheters per year.


RESULTS
There were 491 BSI episodes due to IV catheters, mainly central venous catheters. Episodes per year fell from 110 in 1998 to 48 in 2005 (from 32% of all BSI episodes to 14%; a > 50% reduction). From 1998 to 2005, the rate per 1000 discharges fell from 2.3 to 0.9 (P for trend < 0.0005) and the rate per 1000 patient-days fell from 0.6 to 0.3 (P for trend < 0.0005).


CONCLUSIONS
Our program was associated with a profound drop in the number of IV catheter-related BSIs per year. Active surveillance and intervention programs can lead to substantial and sustained reductions in these common life-threatening infections.
Collignon
Peter J
PJ
Canberra Hospital, Canberra, ACT, Australia. Peter.Collignon@act.gov.au
Dreimanis
Dianne E
DE
Beckingham
Wendy D
WD
Roberts
Jan L
JL
Gardner
Anne
A
D002404:Catheterization / Q000009:adverse effects*; D002405:Catheterization, Central Venous; D002408:Catheters, Indwelling / Q000009:adverse effects; D006746:Hospital Bed Capacity, 500 and over; D006801:Humans; D011446:Prospective Studies; D018805:Sepsis / Q000209:etiology* / Q000517:prevention & control*