Central Line-Associated Bloodstream Infections

Central Line-Associated Bloodstream Infections is a topic covered in the Washington Manual of Medical Therapeutics.

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General Principles

  • S. aureus, S. epidermidis (coagulase-negative staphylococci), aerobic gram-negative species, and Candida spp. are the most common organisms associated with central line-associated bloodstream infections (CLABSI).
  • Subclavian central venous catheters (CVCs) are associated with lower CLABSI rates than internal jugular CVCs, whereas femoral CVCs have the highest rates and should be removed within 72 hours of placement.
  • Strategies for decreasing the incidence of CLABSI include proper hand hygiene, skin antisepsis using an alcohol-based chlorhexidine solution, maximal sterile barrier precautions during insertion, strict adherence to aseptic technique, and removal of nonessential CVCs as soon as possible.1 Subcutaneous tunneling and use of antiseptic-impregnated CVCs may further reduce the incidence of CLABSIs. Routine exchange of CVCs over a guide wire is not recommended.

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