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Central Line-Associated Bloodstream Infections

(CLABSI)

Definition

A central line-associated bloodstream infection (CLABSI) is a serious infection. The infection happens in the bloodstream. It can affect those with a central line catheter. A central line catheter is a long tube inserted into a large vein. It is used to give medicine, nutrition, IV fluids, and chemotherapy.

Chemotherapy In the Bloodstream
Chemotherapy

A central line catheter can be used to deliver chemotherapy.

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A CLABSI can lead to sepsis. Sepsis is life-threatening condition.

Causes

A CLABSI is caused when bacteria gets on a central line catheter. From the catheter, they can get into the bloodstream. This can happen from bacteria that normally live on the skin.

Risk Factors

Things that raise the risk of a CLABSI are:

  • Severe illness
  • Weak immune system
  • An infection elsewhere
  • Long time use of a catheter (more than 48 hours)
  • Problems with the catheter
  • A catheter that is not coated with an anti-germ substance
  • A catheter inserted into a vein in the groin

Symptoms

CLABSI may cause:

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

Diagnosis

The doctor will ask about symptoms and past health. A physical exam will be done.

Tests may include:

  • Blood tests and cultures
  • Urine tests
  • Sputum tests

Tests will confirm if there is bacteria.

Treatment

The goal is to clear the infection. This involves:

  • Antibiotics—medicines to treat the infection
  • Central line care—often, removing the catheter and replacing it with a new one

Prevention

Proper catheter care and cleaning can help reduce the risk of a CLABSI.

RESOURCES:

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

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

CANADIAN RESOURCES:

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

Health Canada
https://www.canada.ca

REFERENCES:

Catheter-related bloodstream infections. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/catheter-related-bloodstream-infection-crbsi. Accessed September 2, 2021.

Central venous catheter. American Thoracic Society website. Available at: https://www.thoracic.org/patients/patient-resources/resources/central-venous-catheter.pdf. Accessed September 2, 2021.

Central venous catheter. EBSCO DynaMed website. Available at: https://www.dynamed.com/procedure/central-venous-catheter. Accessed September 2, 2021.

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 September 2, 2021.

Saugel B, Scheeren TWL, et al. Ultrasound-guided central venous catheter placement: a structured review and recommendations for clinical practice. Crit Care. 2017;21(1):225.

Last reviewed July 2021 by EBSCO Medical Review Board Nicole Meregian, PA  Last Updated: 9/2/2021