Reviewed by Sara Karaba, MD, PhD, MHS, Johns Hopkins University
Patients with central lines are at risk for infection, including when outside the hospital. Surveillance is needed to understand the degree of infectious risk and to be able to prevent outpatient infections.
Oladapo-Shittu and colleagues sought to understand and characterize central line bloodstream infections (CLABSIs) in the “outpatient” setting; that is, present on admission (POA) to the hospital. Applying NHSN definitions to this new time frame, the authors characterized patients with CLABSI-POA from 11 adult and pediatric hospitals across 3 health systems. Over 1 year (November 2020-October 2021), the authors identified 461 CLABSI-POA events, though a rate could not be estimated, as the denominator is not known. Large proportions of identified CLABSI-POA events had either recently received chemotherapy or parenteral nutrition, and 11% died during their hospital stay with increasing age and lack of insurance associated with increased risk of mortality. Catheter removal was associated with decreased mortality risk. This study makes the case to expand infection surveillance beyond the hospital setting to be able to better understand risks and then prevention strategies for this population.
Reference:
Oladapo-Shittu O, Cosgrove SE, Rock C, et al. Characterizing Patients Presenting on Hospital Admission With Central Line-Associated Bloodstream Infections: A Multicenter Study. Clin Infect Dis 2024; 78:1632–1639.