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. 2025 Mar;53(3):361-367.
doi: 10.1016/j.ajic.2024.10.011. Epub 2024 Oct 19.

Targeting prolonged short-term central venous catheters to reduce hospital-wide catheter days and CLABSI rates

Regev Cohen  1 , Shelly Lipman-Arens  2 , Lamis Mahamid  2 , Linor Ishay  2 , Olga Feld Simon  2 , Sharon Reisfeld  2 , Orna Ben-Natan  2 , Aliza Vaknin  2 , Mohammed Ganayem  2 , Razi Abu Hadba  3 , Erez Karisi  4 , Noa Melnik  4 , Sarit Freimann  5 , Maanit Shapira  6 , Nina Avshovich  7 , Ayed Darawshe  8 , Ronit Rachmilevitch  9 , Valery Istomin  9 , Rena Abilevitch  10 , Saif Abu-Mouch  11 , Rotem Novoselsky  12 , Marinella Beckerman  13 , Vlada Dubinchik  14 , Boris Kessel  15 , Veacheslav Zilbermints  15 , Veronika Starobinsky  16 , Inna Furman  16 , Konstantin Neimark  17 , Yaakov Daskal  17 , Mohanad Ganayem  17 , Fanny Biton  3 , Boris Isakovich  17 , Elias Tannous  18
Affiliations

Targeting prolonged short-term central venous catheters to reduce hospital-wide catheter days and CLABSI rates

Regev Cohen et al. Am J Infect Control. 2025 Mar.

Abstract

Background: The risk of central line-associated bloodstream infection (CLABSI) is associated with central venous catheter (CVC) dwelling time. We implemented a hospital-wide intervention aimed to alert physicians to CVC duration and necessity and to improve the monitoring of CLABSI prevention process measures outside the intensive care unit (ICU).

Methods: A retrospective, before-after study that evaluated short-term, nonhemodialysis CVCs in and out of the ICU. The intervention included enhanced bundle-prevention measures monitoring and staff "sensitization" regarding prolonged (> 7 days) CVCs (pCVCs). The ICU intervention also included daily CVC-stewardship visits. We assessed CVC utilizations and CLABSI episodes 20 months before to 19 months after the intervention using Mann-Whitney tests.

Results: Out of the ICU, CVC-utilization ratio (CVC-UR) and pCVC-UR reduced significantly (4.1-2.7/100 hospital days, P = .005; and 28%-21%, P = .02, respectively). Bundle-prevention measures improved, and CLABSI rates reduced postintervention (7.9-3.6/1,000 CVC days, P = .03). In the ICU, pCVC-UR reduced significantly (29%-15%, P < .0001). Baseline ICU-CLABSI rates were low and did not reduce postintervention.

Conclusions: Sensitizing physicians to the existence and duration of CVCs accompanied by improved bundle-prevention measures, resulted in reduction of pCVCs, and outside the ICU, also in reduction of CVC-UR and CLABSI rates.

Keywords: Bundle; Catheter duration; Catheter related bloodstream infection; Idle catheter; Utilization ratio.

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