Mazi Waleed A, Abdulwahab Mohammed H, Alashqar Mahmood A, Aldecoa Yvonne S, Bahat Zaheda R, Suaking Jennifer L, Saeed Amir, Yassin Osama S, Mahfouz Salah Al-Din, Senok Abiola
Infection Prevention and Control, King Faisal Medical Complex, Taif, Kingdom of Saudi Arabia.
Department of Laboratory Sciences, College of Applied Medical Sciences, University of Hail, Hail, Kingdom of Saudi Arabia.
Infect Drug Resist. 2021 Mar 5;14:889-894. doi: 10.2147/IDR.S290791. eCollection 2021.
Central line-associated bloodstream infection (CLABSI) is an important cause of increased morbidity and mortality in ICUs. The occurrence of CLABSI in significantly higher in developing countries and contributes to the burden of healthcare-associated infections.
This prospective study was carried out from January 2016 to December 2019 in the intensive care unit at King Faisal Medical Complex in Taif, Saudi Arabia. The Society for Healthcare Epidemiology of America/Infectious Diseases Society of America (SHEA/IDSA) recommendations were introduced and implemented during 2017-2019. In the post-intervention period, observation of hand hygiene, CLABSI bundle compliance, and benchmarking of CLABSI rates were carried out.
The CLABSI incidence rate was 1.12/1,000 central-line days, with a 0.51 utilization ratio in the pre-intervention period. This dropped to 0.46/1,000 central line days with a 0.44 utilization ratio in the post-intervention period. This reduction was also confirmed in benchmarking with National Healthcare Safety Network (NHSN) (50th-75th) percentile pre-intervention vs (25th-50th) percentile post-intervention. Institutional risk assessment revealed a formal educational program as a potential need for improvement. The CLABSIs were caused predominantly by multidrug-resistant .
We observed a reduction and sustained low incidence rate of CLABSI benchmarking to NHSN for 3 years after implementation of the basic SHEA/IDSA recommendations.
中心静脉导管相关血流感染（CLABSI）是重症监护病房（ICU）发病率和死亡率增加的重要原因。CLABSI在发展中国家的发生率显著更高，增加了医疗相关感染的负担。
本前瞻性研究于2016年1月至2019年12月在沙特阿拉伯塔伊夫市法赫德国王医疗中心的重症监护病房进行。2017 - 2019年期间引入并实施了美国医疗保健流行病学学会/美国传染病学会（SHEA/IDSA）的建议。在干预后阶段，对手卫生、CLABSI集束干预措施依从性以及CLABSI发生率进行了观察。
CLABSI发生率为1.12/1000中心静脉导管日，干预前期的使用率为0.51。干预后期降至0.46/1000中心静脉导管日，使用率为0.44。与国家医疗安全网络（NHSN）的基准比较也证实了这种下降（干预前期处于第50 - 75百分位数，干预后期处于第25 - 50百分位数）。机构风险评估显示正式的教育项目存在潜在改进需求。CLABSI主要由多重耐药菌引起。
在实施基本的SHEA/IDSA建议后，我们观察到CLABSI发生率降低且持续保持低水平，并与NHSN基准进行了3年比较。
