Carl R. Darnall Army Medical Center - Health Library

Central Line-Associated Bloodstream Infections

(CLABSI)

Definition

A central line-associated bloodstream infection (CLABSI) occurs when bacteria enters the bloodstream through a central line catheter. A central line catheter is a long, thin tube that is inserted through a vein until it reaches a larger vein close to the heart. It is used to deliver medication, nutrition, IV fluids, and chemotherapy.

Chemotherapy In the Bloodstream
Chemotherapy

A central line catheter can be used to deliver chemotherapy.

Copyright © Nucleus Medical Media, Inc.

If bacteria start to grow on the central line catheter, they can easily enter the blood and cause a serious infection. This can lead to a condition called sepsis, which occurs when bacteria overwhelm the body.

Causes  ^

Bacteria normally live on the skin. These bacteria will sometimes track along the outside of the catheter. From the catheter, they can get into the bloodstream.

Risk Factors  ^

Factors that may increase your chance of a CLABSI:

  • Having a catheter for a long time
  • Having a catheter that is not coated with an antimicrobial—a substance that kills bacteria
  • Having a catheter inserted into a vein in the thigh
  • Having a weakened immune system
  • Being in the intensive care unit
  • Having an infection elsewhere in the body or skin

Symptoms  ^

CLABSI may cause:

  • Fever
  • Chills
  • Fast heart rate
  • Redness, swelling, or tenderness at the catheter site
  • Drainage from catheter site

Diagnosis  ^

Your doctor will ask about your symptoms and medical history. A physical exam will be done.

Tests may include:

Treatment  ^

Talk with your doctor about the best treatment plan for you. Treatment options include the following:

  • Antibiotics—Antibiotics are medications used to treat an infection. The kind of antibiotic you will be given depends on which bacteria is found in your blood.
  • Central line care—Often, the central line catheter will need to be removed and replaced by a new catheter.

Prevention  ^

At the Hospital

When you are getting a central line placed, the staff will follow a series of steps to reduce your risk of infection.

There are also steps that you can take to reduce your risk of infection:

  • Ask the staff to take every precaution to prevent an infection.
  • Tell the staff right away if the bandage needs to be changed or if the site is red or sore.
  • Ask everyone entering your hospital room to wash their hands. Do not allow visitors to touch your catheter.

At Home

  • Follow all instructions concerning your central line.
  • Learn how to take care of your catheter:
    • Follow specific instructions about showering and bathing.
    • Before touching the catheter, wash your hands or use a hand sanitizer. Wear gloves when touching the area.
    • Change bandages as directed.
    • Wash the catheter caps with an antiseptic.
    • Do not allow anyone to touch the catheter or the tube.
    • Check the insertion site daily for signs of infection, such as redness and swelling.
    • Call your doctor if you think you have an infection.
RESOURCES:

Centers for Disease Control and Prevention
https://www.cdc.gov

Society of Critical Care Medicine
http://www.sccm.org

CANADIAN RESOURCES:

Health Canada
https://www.canada.ca

Canadian Patient Safety Institute
http://www.patientsafetyinstitute.ca

REFERENCES:

Central venous catheter. American Thoracic Society website. Available at: https://www.thoracic.org/patients/patient-resources/resources/central-venous-catheter.pdf. Accessed March 2, 2018.

Central venous catheter. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T146372/Central-venous-catheter. Updated October 25, 2017. Accessed March 2, 2018.

FAQs: Catheter-associated bloodstream infections. Centers for Disease Control and Prevention website. Available at: https://www.cdc.gov/hai/pdfs/bsi/BSI_tagged.pdf. Accessed March 2, 2018.

Last reviewed March 2018 by EBSCO Medical Review Board Michael J. Fucci, DO, FACC  Last Updated: 5/11/2013