Three-year prospective, observational study of central line-associated bloodstream infections in a 600-bed Japanese acute care hospital.
BACKGROUND
Central line-associated bloodstream infection (CLABSI) is an important concern associated with central venous catheter (CVC) use. The objective of this study was to determine the influences of CVC access sites, CVC types, and presumed causative microorganisms on CLABSI occurrence in an acute care hospital.


METHODS
We conducted a prospective, observational study of CLABSI occurrence for 3 consecutive years in a 600-bed Japanese acute care hospital. Data collected included patient characteristics, CVC access sites, CVC types, and microorganisms isolated by blood culture.


RESULTS
For 1,650 CVCs used for 1,237 patients, 39 cases of infection were identified. Most infections had occurred within 1 month of CVC insertion. Maximal sterile barrier precautions had been used for most cases (97.3%). The average CLABSI occurrence days with internal jugular vein access were shorter than those with subclavian vein access and femoral vein access. CLABSI rates were 1.1 and 0.7 for single- and multilumen CVCs, respectively. CLABSI occurrence tended to be shorter when gram-positive cocci were isolated and tended to be longer when fungi (Candida spp) were isolated.


CONCLUSIONS
Most CLABSI cases had occurred within 1 month of CVC insertion. Longer CVC duration increased chance of fungal infection.
Department of Infection Control, Hamamatsu Medical Center, Hamamatsu, Japan; Department of Health Science, Hamamatsu University School of Medicine, Hamamatsu, Japan.
Yasuko
Y
Matsui
Department of Infection Control, Hamamatsu Medical Center, Hamamatsu, Japan.
Michitsugu
M
Shimatani
Department of Infection Control, Hamamatsu Medical Center, Hamamatsu, Japan.
Kenta
K
Kuzuhara
Department of Infection Control, Hamamatsu Medical Center, Hamamatsu, Japan.
Yoshiko
Y
Miyazaki
Department of Infection Control, Hamamatsu Medical Center, Hamamatsu, Japan.
Tomoko
T
Horiuchi
Department of Infection Control, Hamamatsu Medical Center, Hamamatsu, Japan.
Yasuhisa
Y
Tajima
Department of Infection Control, Hamamatsu Medical Center, Hamamatsu, Japan.
Kunio
K
Yano
Department of Health Science, Hamamatsu University School of Medicine, Hamamatsu, Japan. Electronic address: tnagata@hama-med.ac.jp.
Toshi
T
Nagata
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001419:Bacteria / Q000145:classification / Q000302:isolation & purification; D055499:Catheter-Related Infections / Q000453:epidemiology*; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D005260:Female; D005658:Fungi / Q000145:classification / Q000302:isolation & purification; D006761:Hospitals; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D018805:Sepsis / Q000453:epidemiology*; D055815:Young Adult
Central line–associated bloodstream infection; Central venous catheters; Surveillance