What are bloodstream infections associated with catheters and how can they be prevented?

Blood stream infections associated with catheters are estimated to be the cause of some 14,000 deaths annually in this country.  They prolong hospital stays and result in excess costs, which can range between $3700 and $29,000 per hospitalization.  Eliminating blood stream infections associated with catheters has become a national priority.

A “central line” or “central catheter” is a tube that is placed into a patient's large vein, usually in the neck, chest, arm, or groin. The catheter is often used to draw blood, or to give fluids or medications and may be left in place for several weeks. A bloodstream infection can occur when bacteria or other germs travel down a “central line” and enter the blood. Symptoms of a bloodstream infection are fever and chills, or soreness and redness of the skin surrounding the catheter.

Prevention

The risk of infection associated with central lines can be reduced with several key health care provider practices:

1. Proper hand hygiene when caring for the catheter. Soap and water or an alcohol- based waterless hand cleanser help to prevent contamination of the catheter site and resultant infection.
2. Meticulous care when inserting a catheter should be practiced. Health care personnel should practice strict hand hygiene, wear a sterile gown and gloves, and a special cap and mask to keep the area clean. A sterile drape should cover the patient.
3. Prior to the insertion of the central line, the skin should be cleansed with a special skin antiseptic called chlorhexadine.
4. A proper site for the catheter should be chosen. Some blood vessels appear to carry a greater risk of infection. However, this can vary upon individual circumstances and should be assessed by the health care team. Central lines should be removed promptly once they are no longer necessary. The longer the catheter is in place, the greater the risk of infection over time.

What can you do as a patient ?

1. Ask your doctor and nurses to explain to you why you need the catheter and how long you will need it.
2. Discuss the prevention measures listed above with them.
3. Make sure the doctors and nurses wash their hands with soap and water or an alcohol-based hand rub before and after caring for you.  If you do not see them clean their hands, please ask them to do so.
4. If the bandage comes off or becomes wet or dirty, tell your nurse or doctor immediately.
5. Inform your nurse or doctor if the area around your catheter is sore or red.
6. Do not let family and friends who visit touch the catheter or the tubing.
7. Make sure family and friends clean their hands with soap and water or an alcohol-based hand rub before and after they visit you.

For more information visit: http://www.cdc.gov/ncidod/dhqp/pdf/guidelines/BSI_tagged.pdf

View Statewide reports:

• Illinois Statewide Central Line-associated Bloodstream Infection (CLABSI) Report, Adult Intensive Care, 2010
• llinois Statewide Central Line-associated Bloodstream Infection (CLABSI) Report, Neonatal and Pediatric Intensive Care, 2010
• Organisms Involved in Central Line-associated Bloodstream Infections in Illinois, 2010