Trends in surveillance indicators for central catheter-associated bloodstream infections in a tertiary hospital in Switzerland.

CLABSI central line-associated infections healthcare-associated infections surveillance

Journal

The Journal of hospital infection
ISSN: 1532-2939
Titre abrégé: J Hosp Infect
Pays: England
ID NLM: 8007166

Informations de publication

Date de publication:
10 Oct 2024
Historique:
received: 09 07 2024
revised: 25 09 2024
accepted: 29 09 2024
medline: 13 10 2024
pubmed: 13 10 2024
entrez: 12 10 2024
Statut: aheadofprint

Résumé

Central line-associated bloodstream infections (CLABSI) are associated with relevant morbidity and mortality. Longitudinal dynamics in CLABSI incidence and the spectrum of causative microorganisms are limited. We aimed to describe trends in CLABSI incidence, use of central lines, and causative pathogens. We analysed prospectively collected data on CLABSI at a Swiss tertiary care hospital between January 2016 and December 2023. We investigated longitudinal changes of incidence densities, catheter utilization and causative pathogens. A total of 707 CLABSI were observed, corresponding to an incidence density of 1.69 (95% CI 1.56 - 1.81) CLABSI per 1000 catheter-days. There was no significant trend of CLABSI incidence density per 1000 catheter-days (z=0.86, P=0.391), but an increase of catheter utilization ratio (z=8.88, P<0.001). Coagulase-negative staphylococci (CNS) (n=207, 23.4%) and Enterococcus spp. (n=134, 15.2%; E. faecium n=94, 10.6%; E. faecalis n=37, 4.1%; other Enterococcus spp. n=3, 0.34%) were the most frequent causative pathogens. Over the years, the proportion of Enterococcus spp. (z=3.4, P<0.001), driven by an increase of E. faecium (z=3.2, P=0.001), and yeast (z=2.3, P=0.020) increased, whereas CNS decreased (z=-6.1, P<0.001). Prospective CLABSI surveillance indicated stable incidence densities per 1000 catheter-days, but there were significant shifts of causative microorganisms over time.

Sections du résumé

BACKGROUND BACKGROUND
Central line-associated bloodstream infections (CLABSI) are associated with relevant morbidity and mortality. Longitudinal dynamics in CLABSI incidence and the spectrum of causative microorganisms are limited.
OBJECTIVE OBJECTIVE
We aimed to describe trends in CLABSI incidence, use of central lines, and causative pathogens.
METHODS METHODS
We analysed prospectively collected data on CLABSI at a Swiss tertiary care hospital between January 2016 and December 2023. We investigated longitudinal changes of incidence densities, catheter utilization and causative pathogens.
RESULTS RESULTS
A total of 707 CLABSI were observed, corresponding to an incidence density of 1.69 (95% CI 1.56 - 1.81) CLABSI per 1000 catheter-days. There was no significant trend of CLABSI incidence density per 1000 catheter-days (z=0.86, P=0.391), but an increase of catheter utilization ratio (z=8.88, P<0.001). Coagulase-negative staphylococci (CNS) (n=207, 23.4%) and Enterococcus spp. (n=134, 15.2%; E. faecium n=94, 10.6%; E. faecalis n=37, 4.1%; other Enterococcus spp. n=3, 0.34%) were the most frequent causative pathogens. Over the years, the proportion of Enterococcus spp. (z=3.4, P<0.001), driven by an increase of E. faecium (z=3.2, P=0.001), and yeast (z=2.3, P=0.020) increased, whereas CNS decreased (z=-6.1, P<0.001).
CONCLUSIONS CONCLUSIONS
Prospective CLABSI surveillance indicated stable incidence densities per 1000 catheter-days, but there were significant shifts of causative microorganisms over time.

Identifiants

pubmed: 39395465
pii: S0195-6701(24)00328-1
doi: 10.1016/j.jhin.2024.09.019
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2024. Published by Elsevier Ltd.

Auteurs

Tilman Obenhuber (T)

Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich and University of Zurich, Zurich, Switzerland.

Marc Pfister (M)

Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich and University of Zurich, Zurich, Switzerland.

Claudine Reiber (C)

Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich and University of Zurich, Zurich, Switzerland.

Mesida Dunic (M)

Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich and University of Zurich, Zurich, Switzerland.

Christian Falk (C)

Information and Communication Technology, University Hospital Zurich, Zurich, Switzerland.

Walter Zingg (W)

Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich and University of Zurich, Zurich, Switzerland.

Peter W Schreiber (PW)

Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich and University of Zurich, Zurich, Switzerland. Electronic address: peterwerner.schreiber@usz.ch.

Classifications MeSH