Central Line-Associated Bloodstream Infections
A central line-associated bloodstream infection (CLABSI) occurs when bacteria enters the bloodstream through a central line catheter]]>. A central line catheter is a long, thin tube that is inserted through a vein until it reaches a larger vein close to the heart. It is used to deliver medicine, nutrition, IV fluids, and ]]>chemotherapy]]>.
Chemotherapy Through the Bloodstream
If bacteria start to grow on the central line catheter, they can easily enter the blood and cause a serious infection. This can lead to a condition called ]]>sepsis]]>, which occurs when bacteria overwhelm the body. If you suspect you have this condition, call your doctor right away.
Bacteria normally live on the skin. These bacteria will sometimes track along the outside of the catheter. From the catheter, they can get into the bloodstream.
These factors increase your chance of developing a CLABSI:
- Having a catheter for a very long time
- Having a catheter that is not coated with an antimicrobial (a substance that kills bacteria)
- Having a catheter inserted into a vein in the thigh
- Having a weakened immune system
- Being in the intensive care unit
- Having an infection elsewhere in the body or skin
If you have any of these symptoms, do not assume it is due to CLABSI. These symptoms may be caused by other conditions. Tell your doctor if you have any of these:
- Fast heart rate
- Redness, swelling, or tenderness at the catheter site
- Drainage from catheter site
Your doctor will ask about your symptoms and medical history and perform a physical exam.
Tests may include the following:
- Blood tests and cultures—to check blood cells and to check if bacteria are present
- Other cultures—urine, sputum, and/or skin to test for infection
- Echocardiogram]]>—to check the heart to see if bacteria have reached the heart valves
Talk with your doctor about the best treatment plan for you. Treatment options include the following:
- Antibiotics—Antibiotics are medicines used to treat an infection. The kind of antibiotic you will be given depends on which bacteria is found in your blood.
- Central line care—Often, the central line catheter will need to be removed and replaced by a new catheter.
At the Hospital
When you are getting a central line placed, the staff will take the following steps to reduce your risk of infection:
- Carefully choose a safe site to insert the catheter.
- Thoroughly wash their hands or use a hand sanitizer.
- Wear surgical gowns, masks, gloves, and hair coverings.
- Clean the area with antiseptic cleanser.
- Place a sterile sheet over you.
After the central line is in place, the staff will:
- Thoroughly wash their hands and wear gloves before touching the catheter or changing the bandage over the catheter.
- Use an antiseptic to clean the catheter opening.
- Take precautions when handling medicine, fluid, or nutrition that will be delivered through the catheter.
- Keep the catheter in place only as long as it is needed.
- Check the catheter and insertion site daily for signs of infection.
- Not allow visitors in your hospital room when the bandage is being changed.
There are also steps that you can take to reduce your risk of infection:
- Ask the staff to take every precaution to prevent an infection.
- Tell the staff right away if the bandage needs to be changed or if the site is red or sore.
- Ask everyone entering your hospital room to wash their hands. Do not allow visitors to touch your catheter.
- Follow all instructions concerning your central line.
- Learn how to take care of your catheter. Follow these general guidelines:
- Follow specific instructions about showering and bathing.
- Before touching the catheter, wash your hands or use a hand sanitizer. Wear gloves when touching the area.
- Change bandages as directed.
- Wash the catheter caps with an antiseptic.
- Do not allow anyone to touch the catheter or the tube.
- Check the insertion site daily for signs of infection (eg, redness and swelling).
- Call your doctor if you think you have an infection (eg, fever, chills).
Centers for Disease Control and Prevention
Society of Critical Care Medicine
Communicable Disease Control Unit (Manitoba Health)
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Last reviewed October 2009 by ]]>Ronald Nath, MD]]>
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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