Table 1. Risk Factors for CLABSI
Patients at risk for CLABSI in acute care facilities are those with a CVC in place:
a. ICU population: The risk of CLABSI in ICU patients is high.
Reasons for this include:
• The frequent insertion of multiple catheters
• The use of specific types of catheters that are almost exclusively inserted in ICU
patients and are associated with substantial risk (e.g., pulmonary artery catheters with
catheter introducers)
• The fact that catheters are frequently placed in emergency circumstances, repeatedly
accessed each day, and often needed for extended periods of time.
b. Non-ICU population:
Although the primary focus of attention over the last two decades has been the ICU
setting, the majority of CLABSIs occur in hospital units outside of the ICU or in
outpatients.
Infection prevention and control efforts should include other vulnerable populations,
such as:
• Patients receiving hemodialysis through catheters
• Intraoperative patients
• Oncolog y patients
Other catheters besides standard CVCs also carry a risk of infection:
• Short-term peripheral catheters
• Peripherally-inserted central venous catheters (PICCs)
• Midline catheters
• Peripheral arterial catheters also carry a risk of infection
Independent risk factors for CLABSI:
• Prolonged hospitalization before catheterization
• Prolonged duration of catheterization
• Heavy microbial colonization at insertion site
• Heavy microbial colonization of the catheter hub
• Multi-lumen catheters
• Concurrent catheters
• Neutropenia
• Body mass index (BMI) >40
• Prematurity (i.e., early gestational age)
• Reduced nurse-to-patient ratio in ICU
• Parenteral nutrition
• Substandard catheter care (e.g., excessive manipulation of the catheter)
• Transfusion of blood products (in children)
