Eliminating Central Line-associated Blood Stream Infection (CLABSI) on Patients Admitted with Central Lines Through Systematic Assessment and Line Maintenance

2017 ◽  
Vol 45 (6) ◽  
pp. S100-S101
Author(s):  
Abegail Pangan ◽  
Eileen A. Finerty
Keyword(s):  
Blood Stream Infection ◽  
Blood Stream ◽  
Central Line ◽  
Central Lines ◽  
Systematic Assessment

scholarly journals Is it safe to remove central lines in patients with platelets less than 20,000/uL

2021 ◽  
Author(s):  
Priya Marwah ◽  
Stalin Ramprakash ◽  
Sai Prasad T R ◽  
Mane Gizhlaryan ◽  
Deepa Trivedi ◽  
...  
Keyword(s):  
Platelet Transfusion ◽  
Blood Stream Infection ◽  
Blood Stream ◽  
Central Line ◽  
Severe Thrombocytopenia ◽  
Blood Stream Infections ◽  
Central Lines ◽  
Neutropenic Patients ◽  
Bleeding Episodes ◽  
Clinical Risks

Background: Patients with tunnelled CVL may develop blood stream infections which at times are difficult to control without line removal. Concomitant severe thrombocytopenia with platelet transfusion refractoriness is often considered a hard contraindication to any procedure involving a major blood vessel. There is very little literature on the actual clinical risks of tunnelled central line removal in febrile pancytopenic patients. Procedure: We analysed complications and outcomes in all or patients, a total of 52, who underwent CVL removal with platelets <20,000/uL. Results: No bleeding episodes or unplanned transfusions could be associated with CVL removal. No other complications were also reported. All patients had time to hemostasis within 5 minutes of catheter removal. A total 31 patients were febrile at the time of CVL removal, of which 17 became afebrile within 2 days. We found no difference in response when comparing those whose antibiotic therapy was change/escalation versus those who did not. Removal of CVL under local anaesthesia remained complication-free even at platelets counts less than 20.000/uL. With only RDP support 17 lines were pulled out without any complications when platelets were below 5.000. Conclusion: Our findings suggest that central lines can be safely removed with platelet counts less than 20.000/ul and that this may result in enhanced blood stream infection control. This might be particularly relevant to neutropenic patients in this day and age of MDR germs emergence and paucity of new effective antibiotics.

scholarly journals Is it cost effective to use a 2% chlorhexidine wipes bath to reduce central-line associated blood stream infection? A quasi-experimental study

2021 ◽  
Vol 25 (1) ◽  
pp. 101538
Author(s):  
Diego Feriani ◽  
Ercilia Evangelista Souza ◽  
Larissa Gordilho Mutti Carvalho ◽  
Aline Santos Ibanes ◽  
Eliana Vasconcelos ◽  
...  
Keyword(s):  
Experimental Study ◽  
Blood Stream Infection ◽  
Cost Effective ◽  
Blood Stream ◽  
Central Line ◽  
Quasi Experimental

scholarly journals Central Line-Associated Blood Stream Infection During COVID-19 Pandemic

2021 ◽  
Author(s):  
Fatima Aldawood ◽  
Aiman El-Saed ◽  
Mohammed Al Zunitan ◽  
Majed Alshamrani
Keyword(s):  
Blood Stream Infection ◽  
Blood Stream ◽  
Central Line

744 A Quality Improvement Project on Timely Removal of Central Venous Catheters

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
S Devarakonda ◽  
P J Korula ◽  
S Kandasamy
Keyword(s):  
Online Survey ◽  
Blood Stream ◽  
Central Line ◽  
High Morbidity ◽  
Alert System ◽  
Improvement Project ◽  
Central Lines ◽  
Surgical Icu ◽  
Intervention Adherence ◽  
The Mean

Abstract Introduction Central Line-Associated Blood Stream Infections are associated with high morbidity and mortality. It is essential to ensure quality in insertion, maintenance, and timely removal of central lines. Our ICU follows a protocol to remove unused lines after five days. We have an electronic alert system to monitor these lines, and we wanted to audit its usage and improve its efficacy. Method This project was designed using QI methodology and was carried out in a Level III Surgical ICU. We implemented two PDSA cycles in August and December 2020. After the first cycle, an online survey was performed among ICU doctors to gauge their knowledge of the alert system and local protocols. Based on the above results, an educational session was carried out, showing a step-by-step guide to using the alert system, and a re-audit was done in December. Results The first cycle showed that alerts were created for only 17 (25%) of 68 lines. Also, the survey revealed that about 30% of doctors were unfamiliar with the alert system. After the intervention, adherence to the alert system increased to 65% (alerts for 41 of 63 lines). There was also a significant improvement in the mean number of central line days from 6.4 (SD = 3.1) to 4.2 (SD = 2.8) [P &lt;  .05]. Conclusions It is crucial to monitor central lines, and simple educational sessions about local protocols can bring success in implementing sustainable change in quality. We suggest hospitals have systems to monitor the central lines and regularly audit their effectiveness.

scholarly journals Evaluation of Specific Risk Factors and Outcomes of Colistin-Resistant Klebsiella pneumoniae Infections in a Tertiary Care Centre - An Observational Study

2021 ◽  
Vol 4 (2) ◽  
pp. 1-6
Author(s):  
Prakash Shastri ◽  
Shamanth A Shankarnarayan
Keyword(s):  
Risk Factors ◽  
Blood Stream Infection ◽  
Tertiary Care ◽  
Venous Catheter ◽  
Blood Stream ◽  
Central Line ◽  
Multidrug Resistant ◽  
Automated System ◽  
Tertiary Care Centre ◽  
Broth Microdilution Method

Background: Incidence of multidrug resistant Klebsiella pnumoniae infections are increasing globally especially in ICUs. Aim: We evaluated the burden of colistin resistant K. pneumoniae (ColR KP) and the risk factors associated with the outcome of these patients. Methods: Consecutive patients developing K. pneumoniae infections were included. K. pneumoniae from endotracheal tube and catheterized urine sample, having cell count <105 cfu/ml, and which did not necessitate a change in antibiotics as per the treating physicians was considered as colonizer. Demographic and clinical details were collected and samples were processed as per standard protocol. Any growth was identified and its antimicrobial susceptibility was carried out by using Vitek 2 automated system. Minimum inhibitory concentration of >4 μg/ml for Colistin was considered as resistant. The resistant isolates were confirmed with Broth microdilution method. Risk factor associated with the outcome of ColR KP was analyzed. Findings: Burden of K. pneumoniae infection was 50.02 per 1000 admissions. K. pneumonie (n=155) was isolated from patients with ventilator associated pneumonia (84, 54.2%), followed by blood stream infection (49, 31.6%) and urinary tract infection (22, 14.2%). ColR KP and intermediate (ColI KP) isolates were 58 (37.41%) and 97 (62.6%) respectively. Among ColR KP infected patients 32 (55.1%) died whereas 26 (44.8%) patients were discharged. Higher mortality was witnessed in ColI KP cases (75, 77.3%) compared to ColR-KP cases (32, 55.1%) (p=0.004; OR=2.77; 95% CI=1.37 to 5.59). Colistin resistance and presence of central line were independently associated with mortality. Conclusion: Colistin resistant K. pneumoniae infections among ICU patients are on rise. Presence of central venous catheter and resistance to colistin were independent predictors of mortality.

Central Line Associated Blood Stream Infection

2015 ◽  
pp. 303-304
Author(s):  
Lindsay O’Meara ◽  
Khanjan H. Nagarsheth
Keyword(s):  
Blood Stream Infection ◽  
Blood Stream ◽  
Central Line
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