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Am J Infect Control. 2014 Aug;42(8):865-7. doi: 10.1016/j.ajic.2014.05.005.

Central line-associated bloodstream infection in a trauma intensive care unit: impact of implementation of Society for Healthcare Epidemiology of America/Infectious Diseases Society of America practice guidelines.

Author information

1
Infection Prevention and Control Department, King Abdul Aziz Specialists Hospital, Taif, Saudi Arabia. Electronic address: waleed.mazi@ki.se.
2
Infection Prevention and Control Department, King Abdul Aziz Specialists Hospital, Taif, Saudi Arabia.
3
Intensive Care Unit, King Abdul Aziz Specialists Hospital, Taif, Saudi Arabia.
4
Preventive Medicine, Ministry of Health, Riyadh, Saudi Arabia.
5
Department of Microbiology and Immunology, College of Medicine, Alfaisal University, Riyadh, Saudi Arabia.

Abstract

BACKGROUND:

This study aimed to assess the impact implementation of the basic Society for Healthcare Epidemiology of America/Infectious Diseases Society of America (SHEA/IDSA) practice recommendations in reducing central line-associated bloodstream infection (CLABSI) in intensive care units (ICUs).

METHODS:

The prospective study was conducted from January 2011-December 2012 at the 23-bed trauma ICU in Saudi Arabia. The basic SHEA/IDSA practice recommendations were introduced and implemented during the year 2012. Laboratory-confirmed CLABSIs were identified, and the antimicrobial susceptibility of isolates was determined. Data were collected and analyzed for benchmarking with the National Healthcare Safety Network.

RESULTS:

There was a 58% decline in the CLABSI incidence rate from 3.87 to 1.5 per 1,000 central line days in 2011 and 2012, respectively (standardized infection ratio, 0.42; P = .043). Three institutional risk factors were identified and resolved: health care personnel education, removal of nonessential catheters, and use of a catheter cart. Three Klebsiella pneumoniae isolates susceptible only to imipenem, 1 pandrug resistant Acinetobacter baumannii, and 2 Enterococcus faecalis, with 1 isolate resistant to vancomycin, were identified in 2012.

CONCLUSION:

The basic SHEA/ISDA practice recommendation is an effective prevention model for the reduction of CLABSIs in the ICU. Additional measures are needed to control the spread of multidrug-resistant organisms.

KEYWORDS:

Central line‚Äďassociated bloodstream infection; National Healthcare Safety Network benchmarking; Society for Healthcare Epidemiology of America/Infectious Diseases Society of America practice guidelines

PMID:
25087138
DOI:
10.1016/j.ajic.2014.05.005
[Indexed for MEDLINE]

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