STUDY OF CENTRAL LINE-ASSOCIATED BLOODSTREAM INFECTIONS (CLABSI)
Main Article Content
Keywords
Central line-associated bloodstream infection, Carbapenem resistance, Intensive care unit, Antimicrobial stewardship
Abstract
Background:
Central line-associated bloodstream infections (CLABSI) are among the most serious and preventable healthcare-associated infections, carrying attributable mortality of 12–25% and disproportionately higher rates in ICUs of low- and middle-income countries, including India. Institution-specific surveillance is essential to guide targeted prevention in resource-limited tertiary care settings.
Materials and Methods:
An observational, cross-sectional study was conducted over six months (January–June 2019) at Gouri Devi Institute of Medical Sciences & Hospital (GIMSH), Durgapur, West Bengal. Thirty-five adult patients (≥18 years) developing CLABSI during hospitalization were enrolled. Pathogen identification and antimicrobial susceptibility testing (AST) were performed using standard microbiological methods and the Kirby-Bauer disk diffusion technique per CLSI guidelines. Demographic, catheter-related, and clinical outcome data were systematically recorded and analyzed using descriptive statistics.
Results:
The cohort was predominantly male (57.1%) with a mean age of 54.2 ± 16.5 years; 80.0% of infections occurred in ICU patients. Diabetes mellitus (51.4%) was the most prevalent comorbidity. Emergency catheter insertion (68.6%) and catheterization duration exceeding seven days (77.1%; mean: 12.4 ± 5.6 days) were the principal procedural risk factors. Gram-negative bacilli predominated (57.1%), with Klebsiella pneumoniae (22.9%) and Acinetobacter baumannii (17.1%) as the leading pathogens. Alarming resistance rates were observed: 83.3% carbapenem resistance in A. baumannii, 87.5% ceftriaxone resistance (ESBL phenotype) and 50.0% carbapenem resistance in K. pneumoniae, and MRSA in 66.7% of S. aureus isolates. CVC removal was required in 91.4% of cases, 40.0% progressed to septic shock, direct CLABSI-attributable mortality was 14.3%, and mean total hospital stay was 26.5 ± 11.3 days.
Conclusion:
CLABSI imposes a severe and preventable burden predominantly in ICU patients, driven by MDR Gram-negative pathogens and suboptimal catheter practices. Urgent implementation of evidence-based prevention bundles, real-time catheter surveillance, institution-specific antibiograms, and antimicrobial stewardship programs is critical to reducing CLABSI-related morbidity and mortality in resource-limited tertiary care settings.
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Dr.Agnijeet Palit
Assistant Professor, Department of Mcrobiology, Gouri Devi Institute of Medical Sciences & Hospital, Durgapur.
