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Sustained Low Incidence Rates of Central Line-Associated Blood Stream Infections in the Intensive Care Unit

Authors Mazi WA, Abdulwahab MH, Alashqar MA, Aldecoa YS, Bahat ZR, Suaking JL, Saeed A, Yassin OS, Mahfouz SA, Senok A

Received 17 November 2020

Accepted for publication 22 January 2021

Published 5 March 2021 Volume 2021:14 Pages 889—894


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Professor Suresh Antony

Waleed A Mazi,1 Mohammed H Abdulwahab,1 Mahmood A Alashqar,1 Yvonne S Aldecoa,1 Zaheda R Bahat,1 Jennifer L Suaking,1 Amir Saeed,2,3 Osama S Yassin,4 Salah Al-Din Mahfouz,5 Abiola Senok6

1Infection Prevention and Control, King Faisal Medical Complex, Taif, Kingdom of Saudi Arabia; 2Department of Laboratory Sciences, College of Applied Medical Sciences, University of Hail, Hail, Kingdom of Saudi Arabia; 3Department of Medical Microbiology, Faculty of Medical Laboratory Sciences, University of Medical Sciences & Technology, Khartoum, Sudan; 4Intensive Care Unit, King Faisal Medical Complex, Taif, Kingdom of Saudi Arabia; 5Surgeon and Head of Endoscopy, King Faisal Medical Complex, Taif, Kingdom of Saudi Arabia; 6College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates

Correspondence: Waleed A Mazi
Infection Prevention and Control, King Faisal Medical Complex-Taif, P.O. Box: 9970, Taif, 21944, Kingdom of Saudi Arabia
Tel +966504722440
Email [email protected]

Background: 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.
Methods: 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.
Results: 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 Klebsiella pneumoniae.
Conclusion: 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.

Keywords: central line-associated bloodstream infection, SHEA/IDSA, healthcare-associated infections, Saudi Arabia

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