Trends in surveillance indicators for central-catheter-associated bloodstream infections in a tertiary hospital in Switzerland

Background

Central line-associated bloodstream infections (CLABSIs) are associated with relevant morbidity and mortality. Longitudinal dynamics in CLABSI incidence and the spectrum of causative microorganisms are limited.

Aim

To describe trends in CLABSI incidence, use of central lines, and causative pathogens.

Methods

We analysed prospectively collected data on CLABSI at a Swiss tertiary care hospital between January 2016 and December 2023. We investigated longitudinal changes of incidence densities, catheter utilization and causative pathogens.

Findings

A total of 707 CLABSIs were observed, corresponding to an incidence density of 1.69 (95% confidence interval 1.56–1.81) CLABSIs per 1000 catheter-days. There was no significant trend of CLABSI incidence density per 1000 catheter-days (z = 0.86, P=0.391), but an increase of catheter utilization ratio (z = 8.88, P<0.001). Coagulase-negative staphylococci (N = 207, 23.4%) and Enterococcus spp. (N = 134, 15.2%; E. faecium N = 94, 10.6%; E. faecalis N = 37, 4.1%; other Enterococcus spp. N = 3, 0.34%) were the most frequent causative pathogens. Over the years, the proportion of Enterococcus spp. (z = 3.4, P<0.001), driven by an increase of E. faecium (z = 3.2, P=0.001), and yeast (z = 2.3, P=0.020) increased, whereas coagulase-negative staphylococci decreased (z = -6.1, P<0.001).

Conclusions

Prospective CLABSI surveillance indicated stable incidence densities per 1000 catheter-days, but there were significant shifts of causative microorganisms over time.