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Central Line-Associated Bloodstream Infections

(CLABSI)

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
Chemotherapy
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

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

These factors increase your chance of developing a CLABSI:

Symptoms

Symptoms of CLABSI may include:

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:
Your heart may need to be viewed. This can be done with echocardiogram .

Treatment

Talk with your doctor about the best treatment plan for you. Treatment options include the following:

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.
  • 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

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

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

CANADIAN RESOURCES

Health Canada http://www.hc-sc.gc.ca

Safer Healthcare Now! http://www.saferhealthcarenow.ca

References

Central venous catheter. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. 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%5Ftagged.pdf. Accessed August 8, 2013.

Marschall J, Mermel LA, Classen D, et al. Strategies to prevent central line-associated bloodstream infections in acute care hospitals. Infect Control Hosp Epidemiol. 2008;29 Suppl 1:S22-30.

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