Microbiological trends and mortality risk factors of central line-associated bloodstream infections in an academic medical center 2015–2020

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Abstract

Background

Despite tremendous efforts to prevent central line-associated bloodstream infections, they still remain life-threatening complications among hospitalized patients with significant morbidity and mortality worldwide. The emerging antibiotic-resistant bacteria and other risk factors, including patient comorbidities, complicate patient management.

Methods

A single-center retrospective observational study was conducted at King Fahad Hospital of the University, Eastern Province, Saudi Arabia. Hospitalized patients with confirmed central line-associated bloodstream infections between January 2015 and December 2020 were included. The primary objectives were to investigate the trends in antibiotic susceptibility patterns of the causative agents, coexisting comorbid conditions, and other risk factors associated with mortality.

Results

A total of 214 patients with confirmed central line-associated bloodstream infections were included (CLABSI). The overall 30-day mortality rate was 33.6%. The infection rates per 1000 central line days for medical, surgical, and pediatric intensive care units were 4.97, 2.99, and 4.56 per 1000 CL days, respectively. The overall microbiological trends showed a predominance of Gram-negative agents, a steady increase of fungal CLABSI up to 24.0% in 2020, and a high prevalence of multidrug resistance up to 47% of bacterial CLABSI. In addition, the study indicates a significant negative surviving correlation with diabetes mellitus, cardiovascular disease, lung disease, chronic kidney disease, and the presence of ≥ 3 comorbidities (P < 0.05).

Conclusion

The microbiological trends of the study population demonstrated a steady increase of CLABSI caused by Candida spp. with a predominance of Gram-negative pathogens. Stratifying the patients according to relevant mortality risk factors, including patient comorbidities, will help reduce CLABSI rates and improve patient outcomes.

Related collections

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Author and article information

Contributors

Marwan Jabr Alwazzeh: mjalwazzeh@iau.edu.sa

Journal

Journal ID (nlm-ta): Antimicrob Resist Infect Control

Journal ID (iso-abbrev): Antimicrob Resist Infect Control

Title: Antimicrobial Resistance and Infection Control

Publisher: BioMed Central (London )

ISSN (Electronic): 2047-2994

Publication date (Electronic): 19 November 2023

Publication date PMC-release: 19 November 2023

Publication date Collection: 2023

Volume: 12

Electronic Location Identifier: 128

Affiliations

[1 ]GRID grid.412131.4, ISNI 0000 0004 0607 7113, Infectious Disease Division, Department of Internal Medicine, College of Medicine, , Imam Abdulrahman Bin Faisal University, King Fahad Hospital of the University, ; Dammam, Al-Khobar, Saudi Arabia

[2 ]Department of Microbiology, King Fahad Hospital of the University, ( https://ror.org/0230h1q47) Al-Khobar, Saudi Arabia

[3 ]Infection Control Unit, King Fahad Hospital of the University, ( https://ror.org/0230h1q47) Al-Khobar, Saudi Arabia

[4 ]Pharmacy Practice Department, College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, ( https://ror.org/038cy8j79) Dammam, Saudi Arabia

[5 ]Department of Internal Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, ( https://ror.org/038cy8j79) Dammam, Saudi Arabia

[6 ]Department of Microbiology, College of Medicine, Imam Abdulrahman Bin Faisal University, ( https://ror.org/038cy8j79) Dammam, Saudi Arabia

[7 ]Department of Pharmacy Practice, College of Clinical Pharmacy, King Faisal University, ( https://ror.org/00dn43547) Al- Ahsa, Saudi Arabia

Article

Publisher ID: 1338

DOI: 10.1186/s13756-023-01338-5

PMC ID: 10659071

PubMed ID: 37981696

SO-VID: 2711201c-7db3-4d8e-a4bc-b0479e31fd90

License:

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