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Central Line-Associated Bloodstream Infection

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1. Disinfection caps with isopropyl alcohol-impregnated sponges for needleless connectors to reduce central line-associated bloodstream infections

Disinfection caps with isopropyl alcohol-impregnated sponges for needleless connectors to reduce central line-associated bloodstream infections Disinfection caps with isopropyl alcohol–impregnated sponges for needleless connectors to reduce central lineassociated bloodstream infections Disinfection caps with isopropyl alcohol–impregnated sponges for needleless connectors to reduce central lineassociated bloodstream infections HAYES, Inc. Record Status This is a bibliographic record (...) of a published health technology assessment. No evaluation of the quality of this assessment has been made for the HTA database. Citation HAYES, Inc.. Disinfection caps with isopropyl alcohol–impregnated sponges for needleless connectors to reduce central lineassociated bloodstream infections. Lansdale: HAYES, Inc.. Healthcare Technology Brief Publication. 2016 Authors' conclusions Description of Technology: Isopropyl alcohol (IPA) impregnated disinfection caps have recently been introduced as an adjunct

2016 Health Technology Assessment (HTA) Database.

2. Peripherally inserted central catheters are associated with lower risk of bloodstream infection compared with central venous catheters in paediatric intensive care patients: a propensity-adjusted analysis

Peripherally inserted central catheters are associated with lower risk of bloodstream infection compared with central venous catheters in paediatric intensive care patients: a propensity-adjusted analysis PEDSCCM.org Criteria abstracted from series in Review Posted: founded 1995 Questions or comments?

2017 PedsCCM Evidence-Based Journal Club

3. Central lines coated with antibiotics reduce bloodstream infections in children

with heparin – an anti-clotting agent. Antibiotic or heparin coated central lines have long been used in adults to reduce catheter-associated bloodstream infections, but evidence for benefits in children was lacking. This NIHR funded trial provides evidence that use of antibiotic coated central lines could reduce bloodstream infections in paediatric intensive care units. The researchers say cost-effectiveness, based on six-month hospital resource data, will be reported elsewhere. Tis evidence is needed (...) are the implications? This high-quality trial showed that antibiotic coated central lines significantly reduced the risk of bloodstream infections for children in intensive care compared with standard and heparin coated central lines. Preventing healthcare-associated infections, including catheter-associated bloodstream infections, is an NHS priority so widespread use of antibiotic coated central lines in children’s intensive care units should form part of this. The researchers plan to publish a cost-effectiveness

2019 NIHR Dissemination Centre

4. Minimising central line-associated bloodstream infection rate in inserting central venous catheters in the adult intensive care units

Minimising central line-associated bloodstream infection rate in inserting central venous catheters in the adult intensive care units To investigate the procedural aspects in inserting central venous catheters that minimise central line-associated bloodstream infection rates in adult intensive care units through a structured literature review.In adult intensive care units, central line-associated bloodstream infections are a major cause of high mortality rates and increased in costs due (...) duplicates. Papers were scanned for titles and abstract to locate those relevant to the review question. After this, 250 papers were excluded for different reasons and a total of 52 papers were fully accessed to assess for eligibility. The final number of papers included was 10 articles.Many interventions can be implemented in the adult intensive care unit during the insertion of a central venous catheter to minimise central line-associated bloodstream infections rates. These include choosing

2017 EvidenceUpdates

5. Effect of Central Line Bundle Compliance on Central Line-Associated Bloodstream Infections (PubMed)

Effect of Central Line Bundle Compliance on Central Line-Associated Bloodstream Infections The present study aimed to evaluate the effect of central line (CL) bundle compliance on central line-associated bloodstream infections (CLABSIs) in different departments of the same hospital, including the intensive care unit (ICU) and other departments.The four components of the CL bundle were hand hygiene, use of maximal sterile barrier precautions, chlorhexidine use, and selection of an appropriate (...) associated with CLABSIs.This study provides direct evidence that completing all CL bundle components perfectly is essential for preventing CLABSIs. Customized education should be provided, according to specific weaknesses of bundle performance.© Copyright: Yonsei University College of Medicine 2018.

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2018 Yonsei medical journal

6. Impact of discontinuation of contact precautions on central-line associated bloodstream infections in an academic children's hospital. (PubMed)

Impact of discontinuation of contact precautions on central-line associated bloodstream infections in an academic children's hospital. We investigated the impact of discontinuation of contact precautions for methicillin-resistant Staphylococcus aureus and vancomycin-resistant Enterococcus infected or colonized patients on central-line associated bloodstream infection rates at an academic children's hospital. Discontinuation of contact precautions with a bundled horizontal infection prevention

2019 Infection control and hospital epidemiology

7. Development of a Clinical Prediction Model for Central Line-Associated Bloodstream Infection in Children Presenting to the Emergency Department. (PubMed)

Development of a Clinical Prediction Model for Central Line-Associated Bloodstream Infection in Children Presenting to the Emergency Department. The majority of the children with a central line who present to the emergency department with fever or other signs of bacteremia do not have a central line-associated bloodstream infection (CLABSI). Our objective was to develop a clinical prediction model for CLABSI among this group of children in order to ultimately limit unnecessary hospital (...) admissions and antibiotic use.We performed a nested case-control study of children with a central line who presented to the emergency department of an urban, tertiary care children's hospital between January 2010 and March 2015 and were evaluated for CLABSI with a blood culture.The final multivariable model developed to predict CLABSI consisted of 12 factors: age younger than 5 years, black race, use of total parenteral nutrition, tunneled central venous catheter, double-lumen catheter, absence of other

2019 Pediatric Emergency Care

8. Central lines coated with antibiotics reduce bloodstream infections in children

with heparin – an anti-clotting agent. Antibiotic or heparin coated central lines have long been used in adults to reduce catheter-associated bloodstream infections, but evidence for benefits in children was lacking. This NIHR funded trial provides evidence that use of antibiotic coated central lines could reduce bloodstream infections in paediatric intensive care units. The researchers say cost-effectiveness, based on six-month hospital resource data, will be reported elsewhere. Tis evidence is needed (...) are the implications? This high-quality trial showed that antibiotic coated central lines significantly reduced the risk of bloodstream infections for children in intensive care compared with standard and heparin coated central lines. Preventing healthcare-associated infections, including catheter-associated bloodstream infections, is an NHS priority so widespread use of antibiotic coated central lines in children’s intensive care units should form part of this. The researchers plan to publish a cost-effectiveness

2018 NIHR Dissemination Centre

9. Centers for medicare and medicaid services hospital-acquired conditions policy for central line-associated bloodstream infection (CLABSI) and cather-associated urinary tract infection (CAUTI) shows minimal impact on hospital reimbursement. (PubMed)

Centers for medicare and medicaid services hospital-acquired conditions policy for central line-associated bloodstream infection (CLABSI) and cather-associated urinary tract infection (CAUTI) shows minimal impact on hospital reimbursement. In 2008, the Centers for Medicare and Medicaid Services (CMS) stopped reimbursing for hospital-acquired conditions (HACs) not present on admission (POA). We sought to understand why this policy did not impact central line-associated bloodstream infection (...) (CLABSI) and catheter-associated urinary tract infection (CAUTI) trends.Retrospective cohort study.Acute-care hospitals in the United States.ParticipantsFee-for-service Medicare patients discharged January 1, 2007, through December 31, 2011.Using inpatient Medicare claims data, we analyzed billing practices before and after the HAC policy was implemented, including the use and POA designation of codes for CLABSI or CAUTI. For the 3-year period following policy implementation, we determined the impact

2018 Infection control and hospital epidemiology

10. The Impact of 2015 NHSN Catheter-associated Urinary Tract Infection (CAUTI) Definition Change on Central Line-associated Bloodstream Infection (CLABSI) Rates and CLABSI Prevention Efforts at an Academic Medical Center. (PubMed)

The Impact of 2015 NHSN Catheter-associated Urinary Tract Infection (CAUTI) Definition Change on Central Line-associated Bloodstream Infection (CLABSI) Rates and CLABSI Prevention Efforts at an Academic Medical Center. The 2015 changes in the catheter-associated urinary tract infection definition led to an increase in central line-associated bloodstream infections (CLABSIs) and catheter-related candidemia in some health systems due to the change in CLABSI attribution. However, our rates

2018 Infection control and hospital epidemiology

11. Interventions to reduce unnecessary central venous catheter use to prevent central-line-associated bloodstream infections in adults: A systematic review. (PubMed)

Interventions to reduce unnecessary central venous catheter use to prevent central-line-associated bloodstream infections in adults: A systematic review. To identify, describe, and evaluate interventions to reduce unnecessary central venous catheter (CVC) use to prevent central-line-associated bloodstream infections (CLABSIs) in adults.Systematic review.The review has been registered in PROSPERO, an international prospective register of systematic reviews. We searched PubMed, EMBASE (...) , the Cochrane Central Register of Controlled Trials (CENTRAL), and the Cumulative Index to Nursing and Allied Health (CINAHL) from inception until August 28, 2018, to collect experimental and observational studies. We included all studies that implemented interventions to reduce unnecessary CVC use, defined as interventions aimed at improving appropriateness, awareness of device presence, or prompt removal of devices.In total, 1,892 unique citations were identified. Among them, 1 study (7.1

2018 Infection control and hospital epidemiology

12. Taurolidine-Citrate Line Locks Prevent Recurrent Central Line Associated Bloodstream Infection in Pediatric Patients. (PubMed)

Taurolidine-Citrate Line Locks Prevent Recurrent Central Line Associated Bloodstream Infection in Pediatric Patients. This study describes a successful, targeted intervention in central venous access device routine care to decrease central line-associated bloodstream infection. Taurolidine-citrate locks significantly reduced the rate of central line-associated bloodstream infection, particularly Gram-negative organisms without adverse events.

2018 Pediatric Infectious Dsease Journal

13. Impact of the International Nosocomial Infection Control Consortium (INICC)'s Multidimensional Approach on Rates of Central Line-Associated Bloodstream Infection in 14 Intensive Care Units in 11 Hospitals of 5 Cities in Argentina. (PubMed)

Impact of the International Nosocomial Infection Control Consortium (INICC)'s Multidimensional Approach on Rates of Central Line-Associated Bloodstream Infection in 14 Intensive Care Units in 11 Hospitals of 5 Cities in Argentina. OBJECTIVE To analyze the impact of the International Nosocomial Infection Control Consortium (INICC) Multidimensional Approach (IMA) and the INICC Surveillance Online System (ISOS) on central line-associated bloodstream infection (CLABSI) rates in 14 intensive care (...) interventions, (2) education, (3) outcome surveillance, (4) process surveillance, (5) feedback on CLABSI rates and consequences, and (6) performance feedback of process surveillance. Bivariate and multivariate regression analyses were performed using a logistic regression model to estimate the effect of the intervention on the CLABSI rate. RESULTS During the baseline period, 5,118 CL days and 49 CLABSIs were recorded, for a rate of 9.6 CLABSIs per 1,000 central-line (CL) days. During the intervention

2018 Infection control and hospital epidemiology

14. Are antimicrobial peripherally inserted central catheters associated with reduction in central line-associated bloodstream infection? A systematic review and meta-analysis. (PubMed)

Are antimicrobial peripherally inserted central catheters associated with reduction in central line-associated bloodstream infection? A systematic review and meta-analysis. Antimicrobial peripherally inserted central catheters (PICCs) may reduce the risk of central line-associated bloodstream infection (CLABSI). However, data regarding efficacy are limited. We aimed to evaluate whether antimicrobial PICCs are associated with CLABSI reduction.MEDLINE, EMBASE, CINHAL, and Web of Science were (...) . Studies of adults at greater baseline risk of CLABSI experienced greater reduction in CLABSI (RR, 0.20; P = .003).Available evidence suggests that antimicrobial PICCs may reduce CLABSI, especially in high-risk subgroups. Randomized trials are needed to assess efficacy across patient populations.Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. All rights reserved.

2017 American journal of infection control

15. Factors associated with recurrence and mortality in central line-associated bloodstream infections: a retrospective cohort study (PubMed)

Factors associated with recurrence and mortality in central line-associated bloodstream infections: a retrospective cohort study Central line-associated bloodstream infections (CLABSIs) are associated with increased mortality, hospital length of stay, and cost. Antimicrobial treatment guidelines for CLABSIs are primarily based on expert opinion. We hypothesized that shorter antimicrobial treatment duration is associated with decreased 60-day recurrence-free survival.A retrospective cohort study (...) ), and age (HR = 1.021; 95% CI = 1.004-1.037) were associated with mortality or recurrence. The effect of antimicrobial treatment duration appeared to plateau after 15 days.Longer antimicrobial treatment duration in patients with HA-CLABSIs is associated with improved recurrence-free survival during the first 60 days after infection. This effect appears to plateau after 15 days of treatment. Prospective studies are needed to definitively determine the optimal antimicrobial treatment duration for CLABSIs.

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2018 Critical Care

16. Knowledge, attitudes, and practice on the prevention of central line-associated bloodstream infections among nurses in oncological care: A cross-sectional study in an area of southern Italy. (PubMed)

Knowledge, attitudes, and practice on the prevention of central line-associated bloodstream infections among nurses in oncological care: A cross-sectional study in an area of southern Italy. The objectives of the cross-sectional study were to delineate the knowledge, attitudes, and behavior among nurses regarding the prevention of central line-associated bloodstream infections (CLABSIs) and to identify their predisposing factors. A questionnaire was self-administered from September to November (...) 2011 to nurses in oncology and outpatient chemotherapy units in 16 teaching and non-teaching public and private hospitals in the Campania region (Italy). The questionnaire gathered information on demographic and occupational characteristics; knowledge about evidence-based practices for the prevention of CLABSIs; attitudes towards guidelines, the risk of transmitting infections, and hand-washing when using central venous catheter (CVC); practices about catheter site care; and sources of information

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2017 PLoS ONE

17. Review of Strategies to Reduce Central Line-Associated Bloodstream Infection (CLABSI) and Catheter-Associated Urinary Tract Infection (CAUTI) in Adult ICUs. (PubMed)

Review of Strategies to Reduce Central Line-Associated Bloodstream Infection (CLABSI) and Catheter-Associated Urinary Tract Infection (CAUTI) in Adult ICUs. Central line-associated bloodstream infection (CLABSI) and catheter-associated urinary tract infection (CAUTI) are costly and morbid. Despite evidence-based guidelines, Some intensive care units (ICUs) continue to have elevated infection rates. In October 2015, we performed a systematic search of the peer-reviewed literature within (...) components that the 5 most successful (by reduction in infection rates) studies of each infection shared. Interventions that addressed multiple stages within the conceptual model were common in these successful studies. Assuring compliance with infection prevention efforts via auditing and timely feedback were also common. Hospitalists with patient safety interests may find this review informative for formulating quality improvement interventions to reduce these infections.© 2017 Society of Hospital

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2017 Journal of Hospital Medicine

18. Indirect Versus Direct Standardization Methods for Reporting Healthcare-Associated Infections: An Analysis of Central Line-Associated Bloodstream Infections in Maryland. (PubMed)

Indirect Versus Direct Standardization Methods for Reporting Healthcare-Associated Infections: An Analysis of Central Line-Associated Bloodstream Infections in Maryland. Whether healthcare-associated infection data should be presented using indirect (current CMS/CDC methodology) or direct standardization remains controversial. We applied both methods to central-line-associated bloodstream infection data from 45 acute-care hospitals in Maryland from 2012 to 2014. We found that the 2 methods (...) generate different hospital rankings with payment implications. Infect Control Hosp Epidemiol 2017;38:989-992.

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2017 Infection control and hospital epidemiology

19. A Model to Predict Central-Line-Associated Bloodstream Infection Among Patients With Peripherally Inserted Central Catheters: The MPC Score. (PubMed)

A Model to Predict Central-Line-Associated Bloodstream Infection Among Patients With Peripherally Inserted Central Catheters: The MPC Score. BACKGROUND Peripherally inserted central catheters (PICCs) are associated with central-line-associated bloodstream infections (CLABSIs). However, no tools to predict risk of PICC-CLABSI have been developed. OBJECTIVE To operationalize or prioritize CLABSI risk factors when making decisions regarding the use of PICCs using a risk model to estimate (...) ) through the PICC (1 point), and presence of another central venous catheter (CVC) at the time of PICC placement (1 point). The MPC score was significantly associated with risk of CLABSI (P<.0001). For every point increase, the hazard ratio of CLABSI increased by 1.63 (95% confidence interval, 1.56-1.71). The area under the receiver-operating-characteristics curve was 0.67 to 0.77 for PICC dwell times of 6 to 40 days, which indicates good model calibration. CONCLUSION The MPC score offers a novel way

2017 Infection control and hospital epidemiology

20. Catheter removal and outcomes of multidrug-resistant central-line-associated bloodstream infection. (PubMed)

Catheter removal and outcomes of multidrug-resistant central-line-associated bloodstream infection. Central-line-associated bloodstream infections (CLABSIs) are responsible for ∼1/3 of all deaths from healthcare-associated infections in the United States. Of these, multidrug-resistant organisms (MDROs) are responsible for 20% to 67%. However, whether catheter removal affects clinical outcomes for MDRO CLABSIs has not been studied. Our objective was to determine the relationship between failure (...) to remove a central venous catheter (CVC) and 30-day all-cause mortality in patients with MDRO CLABSIs. We used a retrospective cohort from Barnes-Jewish Hospital (1/1/2009-10/1/2015) to study patients with a multidrug-resistant Staphylococcus aureus, Enterococcus species, Enterobacteriaceae, Acinetobacter species, or Pseudomonas aeruginosa CLABSI. Risk factors for 30-day mortality, including catheter removal, were assessed for association with 30-day mortality using Cox proportional hazards models

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2018 Medicine

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