Analyzing central-line associated bloodstream infection prevention bundles in 22 countries: The results of ID-IRI survey

Am J Infect Control. 2022 Dec;50(12):1327-1332. doi: 10.1016/j.ajic.2022.02.031. Epub 2022 Mar 7.

Abstract

Background: Because central line-associated bloodstream infections (CLABSIs) are a significant complication of central venous access, it is critical to prevent CLABSIs through the use of central line bundles. The purpose of this study was to take a snapshot of central venous access bundles in various countries.

Methods: The participants in intensive care units (ICUs) completed a questionnaire that included information about the health center, infection control procedures, and central line maintenance. The countries were divided into 2 groups: those with a low or low-middle income and those with an upper-middle or high income.

Results: Forty-three participants from 22 countries (46 hospitals, 85 ICUs) responded to the survey. Eight (17.4%) hospitals had no surveillance system for CLABSI. Approximately 7.1 % (n = 6) ICUs had no CLABSI bundle. Twenty ICUs (23.5%) had no dedicated checklist. The percentage of using ultrasonography during catheter insertion, transparent semi-permeable dressings, needleless connectors and single-use sterile pre-filled ready to use 0.9% NaCl were significantly higher in countries with higher and middle-higher income (P < .05).

Conclusions: Our study demonstrated that there are significant differences in the central line bundles between low/low-middle income countries and upper-middle/high-income countries. Additional measures should be taken to address inequity in the management of vascular access in resource-limited countries.

Keywords: Bundle; CLABSI; Catheter; Central line; Infection; Sepsis.

MeSH terms

  • Catheter-Related Infections* / epidemiology
  • Catheter-Related Infections* / prevention & control
  • Catheterization, Central Venous* / adverse effects
  • Central Venous Catheters*
  • Cross Infection* / epidemiology
  • Cross Infection* / prevention & control
  • Humans
  • Infection Control / methods
  • Intensive Care Units
  • Patient Care Bundles* / methods
  • Sepsis*
  • Surveys and Questionnaires