centrallineassociated

Centrallineassociated generally refers to central line–associated bloodstream infection, commonly abbreviated CLABSI. It describes a bloodstream infection that occurs in a patient who has a central venous catheter in place or within 48 hours after removal, with no other identifiable source of infection.

Common causative organisms include skin flora such as coagulase-negative staphylococci and Staphylococcus aureus, as well as Enterococcus, Gram-negative bacilli, and Candida species. CLABSIs are considered primary bloodstream infections linked to the central line rather than to an infection at another site.

Risk factors include longer duration of catheter use, multiple lumens, insertion in intensive care settings, the insertion site (with some sites carrying higher risk), inadequate aseptic technique during insertion or care, poor line maintenance, and patient factors such as immunosuppression or severe illness.

Prevention focuses on insertion and maintenance practices. Key measures include maximal barrier precautions and sterile technique during insertion, chlorhexidine skin antisepsis, choosing appropriate catheter sites, daily assessment of catheter necessity with removal when no longer needed, proper hub and line disinfection, and use of antiseptic- or antibiotic-coated catheters in selected patients.

Diagnosis relies on clinical suspicion reinforced by laboratory data. Blood cultures from both the catheter and a peripheral vein may be performed, with interpretation aided by the differential time to positivity. Management typically involves removing or replacing the catheter when feasible and initiating empiric broad-spectrum antibiotics, later tailored to culture results. In some cases, antifungal therapy is needed if Candida is suspected or confirmed.

Epidemiologically, CLABSIs are a major cause of healthcare-associated infection, though rates have declined in many settings due to prevention programs. The condition carries significant morbidity, mortality, and cost but is largely preventable with rigorous care practices.