Central Line-associated Bloodstream Infection (CLABSI) FAQ (adapted from CDC)

Central line-associated bloodstream infections (CLABSIs) are infections associated with the use of central lines or central venous catheters. These catheters are often inserted in a large vein in the neck, chest, groin, or arm for purposes such as giving fluids, blood, medications.
- While standard IVs are used for short term use, central lines can remain in the body for more extended periods if needed.
Central lines are susceptible to infection if not properly inserted or maintained or if left in the patient’s body for longer than needed.
Since central lines interact directly with the patient’s bloodstream, an infection of the catheter is likely to cause a bloodstream infection.

The most common bugs cited for causing CLABSI are coagulase-negative Staphylococci, such as Staphylococcus epidermis.
Other common bugs include Staphylococcus aureus, Enterococcus, E. coli, Klebsiella, and other enteric organisms such as Gram-negative rods and Candida.

Use central lines for appropriate indications and leave in place only as long as needed.
- Appropriate indications include long term use of medication for pain, infection, or other medical issues, providing fluids for nutrition, or to aid with conducting specific medical tests.
Minimize use in those at high risk of CLABSI, such as elderly and immunocompromised patients.
Follow recommended central line practices to prevent infection and maintain sterility by using sterile gloves, sterile gown, cap, mask, and sterile drape during insertion.
Remove as soon as it is no longer needed.
Avoid use for short term purposes, i.e., shorter than six weeks.

(OHI CLABSI BUNDLE or LINK)

Before inserting a central line, ensure that its use is necessary.
Wash your hands before and after handling any of the catheter equipment. Maintenance of sterility during the insertion and removal of the catheter is imperative to preventing infection.
Avoid getting the central line or insertion site wet.
Avoid touching or manipulating the central line as much as possible.

Common signs and symptoms of CLABSI include:
- Redness or soreness around the insertion site
- Fever
- Chills
- Leukocytosis

Treatment of CLABSI includes antibiotic therapy and immediate removal of the central line.
Empiric antibiotic therapy is often started with broad-spectrum antibiotics depending on the patient’s presenting signs and symptoms.
Once blood cultures are obtained and confirmed, antibiotic therapy may be tailored depending on the cultures and sensitivities.

Since CLABSIs already encompass the severe problem of bloodstream infection, the most immediate complication is the progression to sepsis and/or multi-organ failure.

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