Epidemiology of central line-associated bloodstream infections in Quebec intensive care units: a 6-year review

Am J Infect Control. 2012 Apr;40(3):221-6. doi: 10.1016/j.ajic.2011.04.008. Epub 2011 Aug 6.


Background: The burden of central line-associated bloodstream infections (CLABSI) in Canadian intensive care units (ICUs) is not well established. The present study aimed to describe CLABSI epidemiology in Quebec ICUs during 2003-2009.

Methods: The study population was a retrospective dynamic cohort of 58 ICUs that participated in the Surveillance Provinciale des Infections Nosocomiales program during 2003-2009. We calculated annual CLABSI incidence rates (IRs), central venous catheter (CVC) utilization ratios, and case-fatality proportions, and described the pathogens involved. We analyzed data using descriptive statistics and standardized incidence ratios.

Results: A total of 891 CLABSIs were identified during 446,137 CVC-days. In 2003-2009, CLABSI IRs were 1.67 CLABSI/1,000 CVC-days in adult ICUs, 2.20 CLABSIs/1,000 CVC-days in pediatric ICUs, and 4.40 CLABSIs/1,000 CVC-days in neonatal ICUs. Since 2007, CLABSI IRs in adult, pediatric and neonatal ICUs have decreased by 11%, 50%, and 18%, respectively. Pediatric ICUs had the highest CVC utilization ratio (median, 0.61; interquartile range, 0.57-0.66). Coagulase-negative staphylococci caused 53% of the CLABSIs. The proportion of methicillin-resistant Staphylococcus aureus declined from 70% to <40% after 2006.

Conclusions: CLABSIs result in a considerable burden of illness in Quebec ICUs. However, CLABSI IRs have decreased since 2007, and the proportion of methicillin-resistant S aureus has remained <40% since 2006. Continuous surveillance is essential to determine whether these changes are sustainable.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Bacteria / classification
  • Bacteria / isolation & purification
  • Catheter-Related Infections / epidemiology*
  • Catheter-Related Infections / microbiology
  • Catheter-Related Infections / mortality
  • Catheterization, Central Venous / adverse effects*
  • Cohort Studies
  • Female
  • Fungi / classification
  • Fungi / isolation & purification
  • Humans
  • Incidence
  • Intensive Care Units
  • Male
  • Middle Aged
  • Mortality
  • Quebec / epidemiology
  • Retrospective Studies
  • Sepsis / epidemiology*
  • Sepsis / microbiology
  • Sepsis / mortality