An Intervention Based Prevention of Catheter Associated Blood Stream Infection in Adult Critical Care Unit

Abstract

Central line associated blood stream infection (CLABSI) is a device associated infection posing a serious threat among critically ill patients. It also increases the cost of hospital stay, morbidity and mortality. The aim of the study was to implement bundle care approach and identify CLABSI rates post intervention in comparison with the retrospective data. All the patients who were admitted in the ICU with central line (CL) in place were included in our study. The bundle care approach was implemented for all the patients when CL was introduced. We compared the CLABSI rates during the implementation period with the previous year CLABSI rates. The CLABSI rates were compared during the pre-intervention and during the intervention. The pre-intervention rate was 7.48 per 1000 catheter days, whereas the post intervention rates were 1.01 and zero per 1000 catheter days. The etiological agents isolated from CLABSI were Enterobacter aerogenes (30%) followed by Klebsiella pneumonia (20%) and Pseudomonas aeruginosa (20%). Similarly the antibiotic resistance was highest in ceftriaxone (55.5%) and lowest in piperacillin tazobactam (11.1%). A strict adherence to bundle care and proper education of the ICU team members including the doctors and nurses would effectively reduce infection rates. The CLABSI rates were 7.48 per 1000 catheter days in the previous year. However after implementation of bundle care the CLABSI rates reduced to zero.

Keywords

• central line
• bundle care
• infection control
• clabsi rate