Incidence and risk factors of central line associated blood stream infections in private healthcare setting in Western Kenya

Abstract

Background: Central line associated blood stream infections (CLABSIs) represent a critical yet often overlooked aspect of healthcare, particularly in settings with limited resources. Several factors contribute to the heightened prevalence of CLABSIs, including age, gender, compromised immune states, and invasive medical procedures such as catheterization, intubation, and central line placements, which can elevate the risk of microbial transmission among patients. Research reveals that a significant portion of hospitalized patients, ranging from 5% to 15%, contract CLABSIs, with a notable percentage, between 9% and 37%, occurring among those admitted to intensive care units (ICUs).  Broad Objective: To determine the incidence and risk factors associated with Central Line Associated Blood Stream Infections in a private health care setting in Kenya.  Methodology: A prospective study was conducted in all patients admitted to the Intensive Care Units showing signs of infection and meeting the inclusion criteria. Data was collected from each inpatient and all intensive care units on weekly basis and analyzed descriptively.  Results: A total of 19 out of 183 CLABSI incidents were identified, which is an incidence of 10.38 % of 183 eligible CLABSI cases and CLABSI to be 13.4 per1000 central-line days. Gram-negative organism was higher at 52.6 % than Gram-positive organisms at 42.1 %. The catheters inserted in the jugular vein 9.3 %(n=7/75) and Femoral vein 14.2 %( n=1/ 7) are more prone to get infection than those inserted in the sub-clavian vein 10.8 %( n=11/ 101).The duration of central venous catheter is also directly proportional to the incidence of infection, the CVCs > 3-8 days have higher CLABSIs at 57.9% than those with 8 days of central lines with 42.1%.  Conclusion: The study showed a high incidence rate of CLABSIs, raising significant concerns. Infection rates varied by central line insertion site, with jugular and femoral veins posing higher risks. Respiratory diseases were prevalent, suggesting an elevated CLABSI risk for immunocompromised or chronically ill patients. Furthermore, 37% of patients had recent antibiotic exposure, aligning with CDC data linking antibiotics to CLABSI risk