Infection Control Program, Division of Anaesthesiology, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland.
Curr Opin Infect Dis. 2011 Aug;24(4):377-84. doi: 10.1097/QCO.0b013e32834811ed.
This review identifies important findings in the recent literature related to the prevention of central line-associated bloodstream infection (CLABSI).
CLABSI rates obtained through surveillance programs have decreased in recent years. Reasons for this are multifactorial: bundle interventions for practice change; technology; and pressure from benchmarking and public reporting. Many studies on the successful use of bundle strategies have been published in the past 2 years, whereas technology has somewhat disappeared from the literature. Success stories made CLABSI prevention the example of healthcare-associated infection prevention. The overwhelming success of practice change together with emerging public awareness confronts hospitals with serious implementation challenges. Fortunately, a number of implementation guidance articles were published recently, which allow hospitals to detect and overcome implementation barriers.
The efforts made for CLABSI prevention exemplify not only the complexity of the problem but also the creativity and--most recently--success. Although 'zero' risk may not seem a realistic goal, the number of hospitals approaching this idealistic threshold is growing. The evidence is now clear that CLABSI can be reduced most effectively by 'state-of-the-art' insertion technique and catheter care. The question today is not 'what to do' but 'how to do it'.
本文旨在识别与中心静脉导管相关性血流感染（CLABSI）预防相关的近期文献中的重要发现。
近年来，通过监测项目获得的 CLABSI 发生率有所下降。其原因是多方面的：包括实践改变的捆绑干预措施、技术、以及基准比较和公开报告的压力。过去 2 年发表了许多关于捆绑策略成功应用的研究，而技术在文献中却有所减少。CLABSI 预防的成功案例成为了医疗保健相关感染预防的典范。实践改变的巨大成功以及公众意识的出现，使医院面临着严峻的实施挑战。幸运的是，最近发表了一些实施指南文章，使医院能够发现并克服实施障碍。
CLABSI 预防工作不仅体现了问题的复杂性，还体现了创造力，以及最近的成功。虽然“零”风险似乎不太现实，但越来越多的医院正在接近这一理想目标。目前的证据清楚表明，通过“最先进”的置管技术和导管护理可以最有效地降低 CLABSI。现在的问题不是“该做什么”，而是“如何去做”。
