Statement by APIC in response to “CDC Vital Signs on Central Line-Associated Bloodstream Infections”

Washington, DC, March 1, 2011 – “APIC applauds and appreciates the significant reduction in central line-associated bloodstream infections (CLABSIs), described in the new ‘Vital Signs’ Report released today by the Centers for Disease Control and Prevention (CDC). The 58 percent decline in CLABSIs occurring in intensive care units (ICU) in 2009 compared with 2001 reflects a focus by direct care providers, in collaboration with infection preventionists, on improving patient safety and preventing this serious type of health care-associated infection (HAI).

“Most significantly, this means an estimated 6,000 lives of patients have been saved by preventing these often life-threatening bloodstream infections. The critical underlying foundation for these successes has been use of key prevention strategies that are based on scientific evidence outlined by the CDC’s Healthcare Infection Control Practices Advisory Committee in 2002 and a soon-to-be-released 2011 update of its Guidelines for the Prevention of Intravascular Catheter-Related Infections. Prevention of CLABSIs has also been accelerated in many U.S. hospitals by a commitment to targeting zero CLABSIs in all patient care areas where central-line (central-venous catheters) are needed for patient care.

“While progress in preventing CLABSIs has been made in the ICU, the report showed that much work remains to be done in non-critical care areas, including outpatient and ambulatory settings. In particular, the report highlighted hemodialysis centers where central lines are used to administer adjunct treatment.

“Continued progress in preventing HAIs requires adequate resources dedicated to infection prevention and control programs. Healthcare institutions can replicate the CLABSI improvement efforts seen in ICUs by applying similar and equally rigorous prevention strategies and resources in other areas. Staff in outpatient settings, including hemodialysis centers, need resources and infection prevention education, in order for the most up-to-date, evidence-based measures to be applied on a consistent and sustained basis.

“This ‘Vital Signs’ report also highlights the need for partnership between patients and their providers aimed at prevention. In particular, far too many patients in the U.S. are refusing use of an arterio-venous (A-V) fistula for their dialysis; instead, many patients prefer the use of a central line. The risk of bloodstream infection is significantly higher with a central line as compared to an A-V fistula. Therefore, APIC encourages those who need dialysis to adopt ‘fistula first.’

“APIC 2011 President Russ Olmsted said, ‘this report is a milestone in our progress toward elimination of CLABSIs but also a realization that many challenges remain; especially for non-ICU and dialysis settings where central lines are in use.’ “APIC published a Guide to the Elimination of Infections in Hemodialysis, in 2010 which details the steps that each facility needs to take to prevent infections and protect patients. In 2009, APIC also published a Guide to the Elimination of Catheter-Related Bloodstream Infections. Both of these guides illustrate the application of evidence to improve care at the bedside. In addition, APIC recently launched the ‘I believe in zero CLABSIs’ initiative, including an online toolkit designed to help infection preventionists and front-line caregivers access the most current resources to lead CLABSI prevention programs in their facilities.

“Research continues to show that an increasing number of HAIs are preventable by consistent adherence to evidence-based strategies. The new report from the CDC provides compelling evidence that prevention strategies can be successful. APIC believes that continued use and monitoring of these strategies will support ongoing reduction in CLABSI, both in and outside the ICU.”

APIC’s mission is to improve health and patient safety by reducing risks of infection and other adverse outcomes. The association’s more than 14,000 members direct infection prevention programs that save lives and improve the bottom line for hospitals and other healthcare facilities around the globe. APIC advances its mission through education, research, collaboration, practice guidance, public policy and credentialing. Visit APIC online at www.apic.org. For consumer-related information, visit www.preventinfection.org.

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