Trends in surveillance indicators for central-catheter-associated bloodstream infections in a tertiary hospital in Switzerland

Abstract

Background: Central line-associated bloodstream infections (CLABSIs) are associated with relevant morbidity and mortality. Longitudinal dynamics in CLABSI incidence and the spectrum of causative microorganisms are limited.

Aim: To describe trends in CLABSI incidence, use of central lines, and causative pathogens.

Methods: We analysed prospectively collected data on CLABSI at a Swiss tertiary care hospital between January 2016 and December 2023. We investigated longitudinal changes of incidence densities, catheter utilization and causative pathogens.

Findings: A total of 707 CLABSIs were observed, corresponding to an incidence density of 1.69 (95% confidence interval 1.56-1.81) CLABSIs per 1000 catheter-days. There was no significant trend of CLABSI incidence density per 1000 catheter-days (z = 0.86, P=0.391), but an increase of catheter utilization ratio (z = 8.88, P<0.001). Coagulase-negative staphylococci (N = 207, 23.4%) and Enterococcus spp. (N = 134, 15.2%; E. faecium N = 94, 10.6%; E. faecalis N = 37, 4.1%; other Enterococcus spp. N = 3, 0.34%) were the most frequent causative pathogens. Over the years, the proportion of Enterococcus spp. (z = 3.4, P<0.001), driven by an increase of E. faecium (z = 3.2, P=0.001), and yeast (z = 2.3, P=0.020) increased, whereas coagulase-negative staphylococci decreased (z = -6.1, P<0.001).

Conclusions: Prospective CLABSI surveillance indicated stable incidence densities per 1000 catheter-days, but there were significant shifts of causative microorganisms over time.

Keywords: CLABSI; Central-line-associated infections; Healthcare-associated infections; Surveillance.