The following is a summary of “Characterizing patients presenting on hospital admission with central line-associated bloodstream infections: A Multicenter Study,” published in the March 2024 issue of Infectious Diseases by Oladapo-Shittu et al.

Data on central line-associated bloodstream infections (CLABSIs) must be present for patients with long-term central venous catheters (CVCs) outside hospitals, hindering our understanding of risks in these settings.

Researchers conducted a retrospective study to improve understanding of the difficulties faced by patients with CLABSI beyond acute care hospitals by characterizing patients with CLABSI present on admission (POA).

They analyzed patients with CLABSI-POA in eleven hospitals across Maryland, Washington, DC, and Missouri between November 2020 and October 2021. CLABSI-POA was identified using a modified acute care CLABSI definition, and outcomes were obtained from chart reviews. Cox regression analyzed all-cause mortality within 30 days. 

The results assessed 461 patients with CLABSI-POA where CVCs were common in home infusion therapy (32.8%) or oncology clinics (31.2%). Enterobacterales were the most common etiologic agent (29.2%). While 11% died during hospitalization, mortality risk rose with age [(20-44 years HR 11.21 95%CI 1.46-86.22), (45-64 years HR 20.88 95% CI 2.84-153.58), (≥65 years: HR 22.50, 95%CI 2.98-169.93), lack of insurance (HR 2.46, 95% CI 1.08-5.59), while CVC removal decreased it (HR 0.57, 95% CI 0.39-0.84).

Investigators concluded that CLABSI-POA is associated with significant in-hospital mortality, and surveillance is required to understand the burden of CLABSI in the community and identify targets for prevention initiatives outside acute care settings. 

Source: academic.oup.com/cid/advance-article-abstract/doi/10.1093/cid/ciae144/7628879