The Descriptive Epidemiology of Central Line-Associated Bloodstream Infection among Patients in Non-Intensive Care Unit Settings

OBJECTIVE. To review and describe device utilization and central line associated bloodstream (CLABSI) events among patients in a non intensive care unit (ICU) setting and to examine the morbidity and mortality associated with these events. DESIGN. One-year descriptive review. SETTING. A single tertiary center with a 1,200-bed hospital and 209 adult ICU beds. PATIENTS. Hospitalized patients identified as having a CLABSI event attributed to a non-ICU setting. METHODS. The cohort was identified from a prospective infection prevention database. Charts and administrative data sets were reviewed to further characterize the patients. Device utilization ratios (DURs) and CLABSI rates were calculated using National Health and Safety Network (NHSN) CLABSI definitions. Need for ICU stay and crude mortality rates were recorded. RESULTS. A total of 136 patients with 156 CLABSIs were identified, of whom 78 (57%) were being treated for a hematological malignancy (HM). The overall DUR was 0.27. A tunneled line was in place for 118 (76%) of the CLABSI events, and a peripherally inserted central catheter was in place for 32 (21%) of the CLABSI events. The non-ICU CLABSI rate was significantly higher than the concurrent ICU rate (2.1 CLABSIs per 1,000 catheter-days vs 1.5 CLABSIs per 1,000 catheter-days; P = .02). Hospital mortality was 23% in the affected group and was significantly higher in patients with HM. CONCLUSIONS. CLABSI rates over a 1-year period were higher in patients outside the ICU at our hospital and were associated with significant mortality.