CLABSI

PREVENTION
 HEALTH CARE ACQUIRED INFECTION
(HAI)

PROCEDURE DEVICE
ASSOCIATED ASSOCIATED OTHERS
MODULE MODULE

SSI AUR MDRO

VAP VAE
CLABSI CAUTI DE
(MOH REPORT 2021 INTERNATIONAL BENCHMARK)

100% VAE; 0 VAE; 0

90%
VAP; 2.4
80% VAE; 3.22
VAP; 7.9

70%
VAE; 7.76
60%

50% CAUTI; 3.3 VAP; 1.92

40% CAUTI; 5.34

CAUTI; 0.92
30%
VAP; 0.7
20%
CAUTI; 1.71 CLABSI; 2.6 CLABSI; 2.32
CLABSI; 4.93
10%
CLABSI; 0.8
0%
NHSN GCC INICC MOH
WHAT IS CLABSI ?
 CENTRAL LINE ASSOCIATED
BLOOD STREAM INFECTION
(CLABSI)

is defined as a Laboratory Confirmed

Bloodstream Infection (LCBI) that is not
secondary to an infection at another body site
with a central line that has been in place for
more than two consecutive calendar days (on
or after CL day 3).
 An intravascular catheter that terminates at
or close to the heart, OR in one great vessels
that is used for infusion, withdrawal of
blood or hemodynamic monitoring

Yes, improper insertion or maintenance of

central line can lead to Central line-
associated bloodstream infection (CLABSI)

An intravascular catheter that terminates at

or close to the heart, OR in one great vessels
that is used for infusion, withdrawal of
blood or hemodynamic monitoring
CENTRAL
VENOUS
CATHETER
The following are considered great vessels for the
purpose of reporting central line infections and
counting central line days
•Aorta
•Pulmonary artery
•Superior vena cava
•Inferior vena cava
•Brachiocephalic veins
•Internal jugular veins
•Subclavian veins
•External iliac veins
•Inferior vena cava
•Common femoral veins
•In neonates, the umbilical
artery/vein
TYPES OF CENTRAL LINE
Permanent

 Tunneled catheters (including certain

dialysis catheters)
 Implanted catheters (including ports)

Temporary Umbilical Catheter

A central line that is A central vascular device

non-tunneled inserted through the umbilical
artery or vein in a neonate.
Devices not considered as Central Line
 Neither the location of the insertion site nor
the type of device may be used to
determine if a line qualifies as a central
line. The device must terminate in one of
these vessels or near the heart to qualify as
a central line.
 Pacemaker wires and other non-lumened
devices inserted into central blood vessels
or the heart are not considered central lines,
because fluids are not infused, pushed, nor
withdrawn through such devices.
Devices not considered as Central Line
The following devices are not considered
central lines:
•Arterial catheters
•Arteriovenous fistula
•Arteriovenous graft
•Extracorporeal membrane oxygenation
(ECMO)
•Hemodialysis reliable outflow (HERO)
•dialysis catheters
•Non-accessed central line (not accessed nor
inserted during the hospitalization)
•Peripheral IV or Midlines
•Ventricular Assist Device (VAD)
Routes for Contamination of Central Venous Catheters

Microorganisms of CLABSI
What are the RISK FACTORS for CLABSI?
 CLABSI BURDEN
Trend of HAI (Rates) in Adult ICU

3.82

3.37
3.22

2.7

2.6 2.59
1.82 2.32
2.03
1.99
1.6 1.62
1.45

1.07
0.92

0 0 0 0 0
2017 2018 2019 2020 2021
Burden of
CLABSI
in Health
Care
System
How to Prevent or Reduce CLABSI ?

By Implementing CLABSI Preventive Care Bundles

 Insertion Care Bundle

 Maintenance Care Bundle
? What are the Components of Insertion Bundle

Maximum
Ultrasound
Barrier
Hand Hygiene Guidance with
Protection
Sterile Probe

Optimal
Chlorhexidine Catheter Site
Skin antisepsis selection
What are the Components of Central Line Maintenance Bundle
THANK YOU