Title : Incidence, pathogens, and antimicrobial susceptibility of CLABSI in Victorian adult ICUs from 2011 to 2022
Abstract:
Objective:
Central line-associated bloodstream infections (CLABSI) in intensive care units (ICU) are significant healthcare-associated infections, resulting in increased mortality, length of stay, and healthcare costs. This study aims to describe the incidence, pathogens, and antimicrobial susceptibility of CLABSI in adult ICUs across Victoria, to identify priorities in prevention strategies and to guide treatment approaches.
Method:
State surveillance data from 2011 to 2022 were analysed to identify device days and CLABSI events. Pathogen data were analysed to determine the most common organisms, and patterns of antimicrobial resistance were grouped into 3-year time epochs.
Results:
608 events were reported over 751,350 device days. Overall, CLABSI incidence was 0.81 per 1,000 central-line days, with a 49.3% rate reduction from 2011 to 2022 (1.39 to 0.70 per 1,000 central-line days). Overall device utilisation ratio was 0.57, with a 15.4% reduction from 2011 to 2022. Of 690 pathogens, the most common by rank order were coagulase-negative Staphylococci (CNS), Candida species, Staphylococcus aureus, and Enterococcus faecalis. The proportion of CNS-causing events increased by 69.0% from 2011 to 2022; this trend was not observed for other organisms. For every increase in epoch, a 33% decrease in methicillin-resistant S. aureus (MRSA), a 4% increase in vancomycin-resistant Enterococcus faecium, and a 12% increase in ceftriaxone-resistant Escherichia coli pathogens were observed.
Conclusions:
We demonstrate a decreasing incidence of CLABSI in Victorian adult ICUs and an increasing burden of infections due to CNS. No significant time trend increases in antimicrobial-resistant organisms, including MRSA, vancomycin-resistant E. faecium, and ceftriaxone-resistant E. coli were observed.