Central line-associated bloodstream infections
Central line-associated bloodstream infections are one of several health care-associated
infections that patients can get in a health care setting. Health care-associated infections
typically occur 48 hours or more after admission to a facility and are not present at the time of
admission. A central line is a tube placed by a doctor in a large blood vessel in the neck, chest,
groin or arm of a child or adult, or the belly button of a newborn that is used to give fluids. A
central line-associated bloodstream infection occurs whenthis tube becomes infected. If not
cared for correctly or cleaned regularly, these tubes can become a freeway for germs to enter
the body and cause serious bloodstream infections.1
1 CDC. Retrieved from http://www.cdc.gov/vitalsigns
Why is this important?
Central line-associated bloodstream infections can be deadly. It is estimated that up to one in four affected
patients die.1 These infections often lead to additional days in the hospital, which can be expensive for health
care payers, health care organizations and patients. Seventy-eight thousand (78,000) central line-associated
bloodstream infections are estimated to occur yearly in U.S. hospitals and dialysis units.2 Additional costs range
between $7,288 to $29,156 per episode of infection.3
1 CDC. Retrieved from http://www.cdc.gov/vitalsigns
2 Srinivasan, A., et al. (2011). MMWR, 60, 243-248.
3 The Direct Medical Costs of Healthcare-Associated Infections in US Hospitals and the Benefits of Prevention. CDC. 2009.
Where are we?
Source: Patient Safety Program of the Colorado Department of Public Health and Environment
Where do we want to be?
The U.S. Dept. of Health and Human Services National Action Plan stipulates a 50 percent reduction of central
line-associated bloodstream infections in intensive care units and inpatient wards by 2013.4 Although central
line-associated bloodstream infection rates are decreasing in Colorado, constant efforts are needed to ensure
these rates meet the minimum national target goal (central line-associated bloodstream infection rate: 0.63).
4 National
Targets and Metrics (2010). Retrieved from http://www.hhs.gov/ash/initiatives/hai/nationaltargets/index.html
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What is being done?
Any success to eliminate these serious infections will require continued effort from multiple stakeholders
including providers of care, administrators, families, patients and state health departments. Colorado hospitals
are required by law to report these infections. The Patient Safety Program of the Colorado Department of
Public Health and Environment tracks the number of infections reported by facilities and has completed a
validation study to confirm the numbers. The latest findings showed a 34 percent under-reporting of infections.
Validation and monitoring of data must continue to ensure accountability and accurate identification of these
infections. The Patient Safety Program compiles a report released every January that reflects reportable health
care-associated infections, including central line-associated bloodstream infections, by facility within the state.
This report is available to the public.
This report is available to the public on CDPHE’s website:
http://www.cdphe.state.co.us/hf/PatientSafety/HFAcquiredInfectionsReport11.pdf
High-risk groups
All patients with a central line are at risk for a central line-associated bloodstream infection. However, certain
groups are at higher risk for infection and include the following types: elderly, neonates (babies less than 1 year
old), dialysis patients, patients whose immune system is very weak or absent (e.g., cancer patients, transplant
patients), diabetics, and patients who have suffered a burn injury.
Underlying causes
When germs (usually bacteria, viruses or fungus) enter the bloodstream through a central line, serious
infection can occur. The germs can infect catheters by several means: travel from a health care worker’s hands
to the patient and catheter; movement of germs on the patient’s skin from the insertion site along the surface
of the catheter into the blood; contaminated fluids in the central line; unclean devices that provide the fluids;
and movement of germs from other areas of infection in the patient, such as wound infections, into the
bloodstream.
Colorado’s 10 Winnable Battles
Clean Air Clean Water Infectious Disease Prevention
Mental Health and Substance Abuse Obesity Oral Health Safe Food
Injury Prevention
Tobacco Unintended Pregnancy