(1260) Comparative Analysis of CLABSI Rates by Central Line Type in a Multi-Institutional Cohort

Introduction: Central line-associated bloodstream infection (CLABSI) is a significant cause of morbidity and mortality in hospitalized patients. Different types of central lines are believed to carry varying risks of infection, although large-scale studies across all age groups on the relative risk of infection based on line types are lacking. The objective of this study was to define the duration-adjusted risk of central line infection based on line type across all age groups in a multi-institutional cohort of network hospitals.

Methods: Retrospective review of all hospitals within the OSF Healthcare system. Patients with central lines during admission, as well as tunneled central lines, were excluded. The duration-adjusted CLABSI rates for the 4 line types (central venous catheters [CVC], peripherally inserted central venous catheters [PICC], dialysis catheters, and umbilical venous [UV] catheters) were compared using ANOVA. Pairwise comparisons were performed using Tukey HSD test.

Results: 33,025 central lines in 27,830 unique patients from 15 network hospitals were included. 29,829 central lines were placed in adult patients and 3,196 in pediatric patients. The central lines consisted of 14,474 CVCs, 15,092 PICC lines, 2,428 temporary dialysis catheters, and 1,031 UV catheters, with respective line days of 94,355, 163,073, 24,645, and 5,673. There were a total of 308 reported CLABSIs over 287,748 line days, resulting in an overall CLABSI rate of 1.070 per thousand central line days. The CLABSI rates by line type were 1.678 (95% CI 0.958–2.398) for dialysis catheters, 2.193 (95% CI 0.748–3.638) for UV lines, 0.580 (95% CI 0.461–0.698) for PICC lines, and 1.004 (95% CI 0.735–1.273) for CVCs. Pairwise mean comparisons showed that UV catheters had a 1.613 (95% CI 0.482–2.74, p = 0.0014) higher rate compared to PICC lines, CVCs had a 0.424 (95% CI 0.016–0.832, p = 0.037) higher rate than PICC lines, and dialysis catheters had a 1.098 (95% CI 0.331–1.864, p = 0.001) higher rate than PICC lines.

Conclusions: PICC lines have the lowest duration-adjusted CLABSI risk in a heterogeneous population of all age groups. Different diagnostic groups and the severity of illness may independently impact the CLABSI rate, which should be addressed in further studies.