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Multicenter Study
. 2025 Dec:161:108126.
doi: 10.1016/j.ijid.2025.108126. Epub 2025 Oct 12.

Epidemiology of non-central line-associated primary bloodstream infections in a network of Indian hospitals: A prospective surveillance study over 7 years (2017-2024)

Ashish Kumar Srivastava  1 , Arpan Kumar Thakur  1 , Kumari Vandana Singh  1 , Rasna Parveen  1 , Mamta Puraswani  1 , Parul Singh  1 , Arunaloke Chakrabarti  2 , Camilla Rodrigues  3 , Pallab Ray  4 , Manisha Biswal  2 , Neelam Taneja  2 , Shivaprakash M Rudramurthy  2 , Archana Angrup  2 , Inderpaul Sehgal  2 , Ritesh Agarwal  5 , Chand Wattal  6 , Vimala Venkatesh  7 , Nandini Sethuraman  8 , Sanjay Bhattacharya  9 , Vijaya Lakshmi Nag  10 , Vibhor Tak  10 , Bijayini Behera  11 , Vinaykumar Hallur  11 , Veeraragavan Balaji  12 , Raja Ray  13 , Sanjeev K Singh  14 , Chiranjay Mukhopadhyay  15 , Joy Sarojini Michael  12 , Bashir Ahmad Fomda  16 , Tadepalli Karuna  17 , Vijayshri Deotale  18 , Amber Prasad  19 , Tapan Majumder  20 , Puneet Kumar Gupta  19 , Kanne Padmaja  21 , Vijeta Bajpai  22 , Jyoti Iravane  23 , Reema Nath  24 , Renu Gur  25 , Nari M Lyngdoh  26 , Clarissa Lyngdoh  27 , Sheela Devi  28 , Shalini Malhotra  29 , Rajni Gaind  30 , Ranjana Devi Khuraijam  31 , Rajni Sharma  32 , Summaiya Mullan  33 , John Antony Jude Prakash  12 , Shaoli Basu  34 , Hema Paul  12 , Priscilla Rupali  35 , Sheetal Verma  7 , M A Thirunarayan  8 , Hirak Jyoti Raj  13 , Rushika Saxena  36 , Sangita Rajdev  33 , Neeraj Goel  6 , Sudipta Mukherjee  37 , Yamunadevi V Ramanathan  8 , Juliah Chelliah  3 , Satyam Mukherjee  9 , Aparna Sonowal  24 , Sharmila Sen Gupta  38 , Prachi Verma  39 , Jayashree Muralidharan  40 , Lakshmi Narayana Yaddanapudi  2 , Ajay Duseja  41 , Kajal Jain  2 , Usha Dutta  41 , Parthasarathi Bhattacharyya  42 , Ashoka Mahapatra  11 , Tapas Kumar Som  43 , Rashmi Ranjan Das  44 , Swagata Tripathy  45 , Tushar Mishra  46 , Anupam Dey  47 , Vandana Ke  15 , Muralidhar Varma  48 , Balram Ji Omar  19 , Ankit Aggarwal  19 , Sherish Baqal  16 , Langpoklakpam Chaoba Singh  49 , Neeraj Gupta  50 , Pradeep Kumar Bhatia  51 , Kuldeep Singh  52 , Daisy Khera  52 , D Himanshu  53 , Sarika Gupta  54 , Zia Arshad  54 , Ullash Bhabor  33 , Rahul Sarode  22 , Satyajit Pradhan  55 , Sivanantham Krishnamoorthi  56 , Shalini Dewan Duggal  25 , Rajender Kumar  57 , G P Kaushal  58 , Vikas Dabas  58 , Subodh Kumar  59 , Kapil Dev Soni  60 , Sushma Sagar  59 , Richa Aggarwal  60 , Gyaninder Pal Singh  61 , Ashish Bindra  61 , Kamran Farooque  62 , Kamini Walia  63 , Purva Mathur  64
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Free article
Multicenter Study

Epidemiology of non-central line-associated primary bloodstream infections in a network of Indian hospitals: A prospective surveillance study over 7 years (2017-2024)

Ashish Kumar Srivastava et al. Int J Infect Dis. 2025 Dec.
Free article

Abstract

Objectives: To estimate the profile of non-central line-associated primary bloodstream infections (non-CLABSIs) in intensive care units of Indian hospitals participating in the standardized health-care-associated infection surveillance program.

Methods: This is a multicentric, network-based, prospective surveillance study conducted in 180 individual intensive care units of 47 Indian tertiary care hospitals that were part of the Health-Care-Associated Infection Surveillance Network between May 2017 and April 2024. The non-CLABSIs were defined, monitored, and observed using standardized definitions and surveillance protocols (www.haisindia.com).

Results: A total of 7092 laboratory-confirmed non-CLABSI cases and 30,74,954 patient days from 2017 to 2024 were recorded. The overall pooled non-CLABSI rate was 2.3 per 1000 patient days. Gram-negative isolates were the most predominant (5240/7659; 68.4%), including Klebsiella spp. (1766/5240; 33.7%), Acinetobacter baumannii (1613/5240; 30.8%), and Escherichia coli (582/5240; 11.1%). Gram-positive isolates (1728/7659; 22.6%) predominantly included Staphylococcus aureus (953/1728; 55.1%) and Enterococcus spp. (747/1728; 43.2%). Carbapenem resistance was common in Gram-negative infections, particularly in A. baumannii (1253/1554; 80.6%) and Klebsiella spp. (1209/1697; 71.2%). Among Gram-positive, S. aureus exhibited a high level of resistance to methicillin (529/748; 70.7%).

Conclusions: This surveillance study underscores the need to expand infection prevention and control strategies to include non-device-associated risk factors. This will lead to the formulation of comprehensive infection prevention and control programs, mitigating the burden and clinical outcomes of non-CLABSI.

Keywords: Health-care-associated infection; Non-CLABSI; Non-central line-associated primary bloodstream infection; Surveillance.

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Declaration of competing interest The authors have no competing interests to declare.

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