(CLABSI)
Definition
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 Through the Bloodstream
A central line catheter can be used to deliver
chemotherapy.
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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
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
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
Symptoms
CLABSI may cause:
- Fever
- Chills
- Fast heart rate
- Redness, swelling, or tenderness at the catheter site
- Drainage from catheter site
Diagnosis
Diagnosis
Your doctor will ask about your symptoms and medical history. A physical exam will be done.
Your bodily fluids may be tested. This can be done with:
- Blood tests and cultures
- Urine tests
- Sputum tests
Your heart may need to be viewed. This can be done with echocardiogram.
Treatment
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
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.
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Learn how to take care of your catheter. Follow these general guidelines:
- 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:
Society of Critical Care Medicine http://www.sccm.org
CANADIAN RESOURCES:
References:
http://www.ebscohost.com/dynamed
Updated July 25, 2013. Accessed August 8, 2013.
Central venous catheterization. American Thoracic Society website. Available at:
http://www.thoracic.org/clinical/critical-care/patient-information/icu-devices-and-procedures/central-venous-catheterization.php
Accessed August 8, 2013.
FAQs: Catheter-associated bloodstream infections. Centers for Disease Control and Prevention website. Available at:
http://www.cdc.gov/hai/pdfs/bsi/BSI_tagged.pdf
Accessed August 8, 2013.
Marschall J, Mermel LA, et al. Strategies to prevent central line-associated bloodstream infections in acute care hospitals. Infect Control Hosp Epidemiol. 2008;29 Suppl 1:S22-S30.
Last Updated: 5/11/2013