Effectiveness of enhanced check during acute phase to reduce central venous catheters-associated bloodstream infections: a before-after, real-world study

Background: To evaluate the effectiveness of enhanced check to the duration of the central venous catheters associated bloodstream infections (CABSIs), and the impact on infection rates. Methods: A before-after, real-world study in six adult intensive care units was conducted. All adult patients who had only one central venous catheter were included during two consecutive periods. The intervention period, added cross-check that all patients with central venous catheter (CVC) need to be performed, and included nurses' checks for insertion practices and doctors' checks for maintenance practices. Propensity scores matching were used to account for potential confounding, and restricted cubic spline was served as visualizing the CABSI risk. Results: A total of 2906 patients with 26,157 CVC-days were analyzed. After intervention, the density incidence of CABSI decreased from 10.24 to 6.33/1,000 CVC-days (P < 0.001), and the acute period of rapid increase in CABSI risk was shortened, 6.5 to 5 days for femoral-vein catheterization and 7 to 5.5 days for subclavian-vein catheterization. For jugular-vein catheterization, the acute onset period disappeared. Conclusion: Enhanced check during the first 7 calendar days after CVC insertion shortens the duration of the CABSI acute phase and tends to decrease CABSI rate.