Central Line-Associated Bloodstream Infections and MRSA Blood Infections

A central line-associated bloodstream infection (CLABSI) is one type of HAI in which bacteria enter a person’s bloodstream via a central line. A central line is a type of IV catheter that is placed into a large vein of the body and can be used for many purposes, including administering medications and IV fluids, measuring blood pressure, and removing blood for laboratory testing. It is important to prevent sources of infection from central lines, because once an infection gains entry into the bloodstream, it can quickly spread throughout the body.

Methicillin-resistant Staphylococcus aureus (MRSA) is a type of Staph bacteria that has developed an immunity to several types of antibiotics. MRSA infections are much more difficult to treat because there are fewer medications to effectively treat it.

Though we don’t often think about it, our bodies are covered with bacteria, most of which do not cause us any harm. In fact, many of the bacteria that live on our skin are actually helpful. However, when the skin barrier is broken or the immune system is weak, there is an increased risk that one or more of those normally harmless bacteria could enter into the body and cause an infection. According to the CDC, studies indicate that about 2 of every 100 people have MRSA bacteria that live on their skin surface. MRSA could gain access to the bloodstream by spreading from another part of the body or by entry around or through a central line.

How does UAB Medicine perform?

Standardized infection ratio (SIR) is a number used to measure, track, and comparehealth care-associated infections (HAIs) among different health care settings and providers. This number compares the actual number of HAIs at eachhealth care setting to the predicted number of infections based upon the type of patients treated in that particular setting. The national standard for the SIR is 1. Numbers greater than 1 indicate that the medical center is associated with more HAIs than predicted, while numbers smaller than 1 indicate that the medical center is associated with fewer HAIs than predicted.

 

Safe Care Measures National Benchmark for SIR UAB SIR Comparison Analysis
CLABSI (central line-associated bloodstream infection) 1.0 0.431  
MRSA (methicillin-resistant Staphylococcus aureus) blood infection 1.0 1.022  

 

What is UAB Medicine doing to improve?

UAB Medicine’s CLABSI prevention bundle uses the following evidence-based strategies. A bundle is a set of 3-5 health care practices that have been proven to reduce infection rates when used consistently together as a group. The CLABSI prevention bundle includes the following strategies:

  • Promptly remove central lines that are no longer essential. Similar to our practice with urinary catheters, staff evaluate for the continued need of the central line daily with a goal of removing lines when they are no longer truly needed. Removing central lines at the earliest opportunity reduces the risk of infection.
  • Central lines are only to be placed under sterile conditions and only accessed using sterile technique.
  • Another intervention taken involves using a powerful antibacterial agent called chlorhexidine. Chlorhexidine is a chemical that is often used to clean the skin of patients before surgery; it kills germs by creating holes in their outer surface. Because the skin is covered with bacteria and germs we cannot see, chlorhexidine can be used as a treatment to help prevent infection from occurring when the skin barrier is interrupted by a medical device like a central line. UAB Medicine encourages every patient with a central line to agree to daily bathing with chlorhexidine. To further decrease our patients’ risk of CLABSI, UAB Medicine recently began using central line dressings that contain chlorhexidine.