Researchers conducted a CLABSI surveillance study at a 40-bed medical-surgical ICU and in two 40-bed step-down units in a hospital São Paulo, Brazil, from January 2001 to December 2012. During the first part of the study, the hospital personnel implemented Centers for Disease Control and Prevention evidence-based practices, including sterile barrier precautions and 2 percent chlorhexidine skin antisepsis. During the second part of the study, they implemented a central-line bundle from IHI.
The study found:
1. More than 3,300 CLABSIs with 397 organisms occurred during the 12-year surveillance period.
2. Bloodstream infection rates dropped by 57.3 percent between the two study phases. Central line use in phase 1 was 0.48 percent compared with 0.54 percent in phase 2, with no difference in the types of venous catheters.
3. Mean incidence rates were reduced for gram-positive organisms (from 1.9 to 0.7 organisms per 1,000 central-line days), gram-negative rods (1.4 to 0.7) and fungi (0.7 to 0.3), but not significantly.
“Our study provides insight into the influence of IHI central-line bundle on CLABSIs with a reduction in the incidence of pathogens but no change in the microbiological pattern over the 12-year surveillance period,” concluded the research authors.
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