Incidence, risk factors and healthcare costs of central line-associated nosocomial bloodstream infections in hematologic and oncologic patients

PLoS One. 2020 Jan 24;15(1):e0227772. doi: 10.1371/journal.pone.0227772. eCollection 2020.

Abstract

Non-implanted central vascular catheters (CVC) are frequently required for therapy in hospitalized patients with hematological malignancies or solid tumors. However, CVCs may represent a source for bloodstream infections (central line-associated bloodstream infections, CLABSI) and, thus, may increase morbidity and mortality of these patients. A retrospective cohort study over 3 years was performed. Risk factors were determined and evaluated by a multivariable logistic regression analysis. Healthcare costs of CLABSI were analyzed in a matched case-control study. In total 610 patients got included with a CLABSI incidence of 10.6 cases per 1,000 CVC days. The use of more than one CVC per case, CVC insertion for conditioning for stem cell transplantation, acute myeloid leukemia, leukocytopenia (≤ 1000/μL), carbapenem therapy and pulmonary diseases were independent risk factors for CLABSI. Hospital costs directly attributed to the onset of CLABSI were 8,810 € per case. CLABSI had a significant impact on the overall healthcare costs. Knowledge about risk factors and infection control measures for CLABSI prevention is crucial for best clinical practice.

MeSH terms

  • Adult
  • Age Factors
  • Bacteremia / economics
  • Bacteremia / epidemiology*
  • Bacteremia / microbiology
  • Bacteria / isolation & purification
  • Case-Control Studies
  • Catheter-Related Infections / economics
  • Catheter-Related Infections / epidemiology*
  • Catheter-Related Infections / microbiology
  • Catheterization, Central Venous / adverse effects*
  • Catheterization, Central Venous / instrumentation
  • Central Venous Catheters / adverse effects
  • Cross Infection / economics
  • Cross Infection / epidemiology*
  • Cross Infection / microbiology
  • Female
  • Health Care Costs / statistics & numerical data*
  • Hematologic Neoplasms / therapy
  • Hospitalization / economics
  • Hospitalization / statistics & numerical data
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Retrospective Studies
  • Risk Factors

Grants and funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.