Alshahrani Khadejah M, Alhuwaishel Afnan Z, Alangari Norah M, Asiri Malak A, Al-Shahrani Norah A, Alasmari Ahmed A, Alzahrani Osama J, Ayedh Abdulaziz Y, Qitmah Meshari M
Department of Internal Medicine, Aseer Central Hospital, Abha, SAU.
Department of Internal Medicine, King Fahad Medical City, Riyadh, SAU.
Cureus. 2023 Jun 25;15(6):e40954. doi: 10.7759/cureus.40954. eCollection 2023 Jun.
Background A central line-associated bloodstream infection (CLABSI) is defined as a primary bloodstream infection (BSI) in a patient that had a central line within the 48-hour period before the development of the BSI and is not bloodstream-related to an infection at another site. CLABSI is a common healthcare-associated infection and a significant cause of morbidity and mortality. Methods This systematic review included studies published within the past 13 years that examined risk factors and clinical impact variables associated with CLABSI, using the Centers for Disease Control (CDC)/National Healthcare Safety Network (NHSN) criteria for defining catheter-associated infection, and included participants of all ages. The terms "CLABSI," "central line-associated bloodstream infection," "risk factors," "predictors," "morbidity," "mortality," "healthcare costs," and "length of hospital stay" were used to find relevant publications on PubMed/Medline, Google Scholar, and Science Direct. The quality assessment of the included publications utilized the modified Newcastle-Ottawa scale (NOS) for observational studies. Results After the full-text screening, we identified 15 articles that met our inclusion and exclusion criteria. The majority of these studies were of good quality and had a low risk of bias based on our bias assessment. The studies included a total of 32,198 participants and covered a time period from 2010 to 2023. The mean age of the male patients included in the studies ranged from 0.1 months to 69.1 years. All of the included studies were either observational cohort studies, cross sectional studies, case-control studies, or case reports. The major study parameters/outcomes extracted were risk factors, CLABSI-associated mortality, hospital cost, length of hospital stay, and catheter days. With respect to predisposing factors, multilumen access catheters were identified as risk factors in three studies, use of more than one central venous catheter per case in four studies, hematologic malignancy in three studies, catheterization duration in four studies, surgical complexity in four studies, length of ICU stays in three studies, and parenteral nutrition in two studies. Conclusion The decision to place a venous device should be carefully considered by evaluating individual risk factors for the development of CLABSI. This is important due to the potential for severe clinical consequences and significant healthcare expenses associated with this complication.
中心静脉导管相关血流感染（CLABSI）被定义为患者在发生血流感染前48小时内有中心静脉导管且该血流感染与其他部位感染无关的原发性血流感染（BSI）。CLABSI是一种常见的医疗相关感染，也是发病和死亡的重要原因。方法：本系统评价纳入了过去13年发表的研究，这些研究使用疾病控制中心（CDC）/国家医疗安全网络（NHSN）定义导管相关感染的标准，研究与CLABSI相关的危险因素和临床影响变量，纳入所有年龄段的参与者。使用“CLABSI”“中心静脉导管相关血流感染”“危险因素”“预测因素”“发病率”“死亡率”“医疗费用”和“住院时间”等术语在PubMed/Medline、谷歌学术和科学直投上查找相关出版物。纳入出版物的质量评估采用观察性研究的改良纽卡斯尔-渥太华量表（NOS）。结果：经过全文筛选，我们确定了15篇符合纳入和排除标准的文章。根据我们的偏倚评估，这些研究中的大多数质量良好，偏倚风险较低。这些研究共纳入32198名参与者，涵盖2010年至2023年的时间段。纳入研究的男性患者平均年龄从0.1个月到69.1岁不等。所有纳入研究均为观察性队列研究、横断面研究、病例对照研究或病例报告。提取的主要研究参数/结果为危险因素、CLABSI相关死亡率、医院费用、住院时间和导管使用天数。关于易感因素，三项研究将多腔接入导管确定为危险因素，四项研究将每例使用多个中心静脉导管确定为危险因素，三项研究将血液系统恶性肿瘤确定为危险因素，四项研究将置管持续时间确定为危险因素，四项研究将手术复杂性确定为危险因素，三项研究将重症监护病房住院时间确定为危险因素，两项研究将肠外营养确定为危险因素。结论：应通过评估CLABSI发生的个体危险因素，谨慎考虑放置静脉装置的决定。由于这种并发症可能导致严重的临床后果和巨大的医疗费用，这一点很重要。
