• Alexandre R Marra, Ruy Guilherme Rodrigues Cal, Marcelino Souza Durão, Luci Correa, Luciana Reis Guastelli, Denis Faria Moura, Michael B Edmond, and Oscar Fernando Pavão Dos Santos.
• Intensive Care Unit, Hospital Israelita Albert Einstein, São Paulo, Brazil. alexmarra@einstein.br
• Am J Infect Control. 2010 Aug 1;38(6):434-9.

BackgroundCentral line-associated bloodstream infection (CLABSI) is one of the most important health care-associated infections in the critical care setting.MethodsA quasiexperimental study involving multiple interventions to reduce the incidence of CLABSI was conducted in a medical-surgical intensive care unit (ICU) and in 2 step-down units (SDUs). From March 2005 to March 2007 (phase 1 [P1]), some Centers for Disease Control and Prevention evidence-based practices were implemented. From April 2007 to April 2009 (P2), we intervened in these processes at the same time that performance monitoring was occurring at the bedside, and we implemented the Institute for Healthcare Improvement central line bundle for all ICU and SDU patients requiring central venous lines.ResultsThe mean incidence density of CLABSI per 1000 catheter-days in the ICU was 6.4 in phase 1 and 3.2 in phase 2, P < .001. The mean incidence density of CLABSI per 1000 catheter-days in the SDUs was 4.1 in phase 1 and 1.6 in phase 2, P = .005.ConclusionThese results suggest that reducing CLABSI rates in an ICU setting is a complex process that involves multiple performance measures and interventions that can also be applied to SDU settings.Copyright 2010 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

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